Provider Demographics
NPI:1245345040
Name:MCNAMARA, BRIDGET A (PT)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 CARROLL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-3072
Mailing Address - Country:US
Mailing Address - Phone:203-470-0991
Mailing Address - Fax:
Practice Address - Street 1:52 BEACH RD STE 207
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6017
Practice Address - Country:US
Practice Address - Phone:203-255-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist