Provider Demographics
NPI:1841410149
Name:MCENEANEY, MARY-JANE LYNAM (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY-JANE
Middle Name:LYNAM
Last Name:MCENEANEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 FORT WASHINGTON AVE
Mailing Address - Street 2:APT 21 A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2054
Mailing Address - Country:US
Mailing Address - Phone:203-451-0355
Mailing Address - Fax:
Practice Address - Street 1:16 E 60TH ST
Practice Address - Street 2:SUITE 440
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1096
Practice Address - Country:US
Practice Address - Phone:212-326-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420465-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health