Provider Demographics
NPI:1821357674
Name:YERKE-MCNAMARA, JENNIFER ANN (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:YERKE-MCNAMARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:YERKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5959 BIG TREE RD
Mailing Address - Street 2:STE 107
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2291
Mailing Address - Country:US
Mailing Address - Phone:716-260-1593
Mailing Address - Fax:716-771-3903
Practice Address - Street 1:5959 BIG TREE RD
Practice Address - Street 2:STE 107
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2291
Practice Address - Country:US
Practice Address - Phone:716-260-1593
Practice Address - Fax:716-771-3903
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03890466Medicaid
NY03890466Medicaid