Provider Demographics
NPI:1265836944
Name:MCNEIL, ANNETTE A (MSW)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:A
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BAY WAY
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7348
Mailing Address - Country:US
Mailing Address - Phone:908-229-1999
Mailing Address - Fax:
Practice Address - Street 1:43 BAY WAY
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7348
Practice Address - Country:US
Practice Address - Phone:908-229-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL00540700104100000X
NJ2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty