Provider Demographics
NPI:1356382444
Name:MCBRIDE, TERENCE A (CRNA)
Entity type:Individual
Prefix:MR
First Name:TERENCE
Middle Name:A
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:TERENCE
Other - Middle Name:A
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:37 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2142
Mailing Address - Country:US
Mailing Address - Phone:201-316-7331
Mailing Address - Fax:
Practice Address - Street 1:37 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2142
Practice Address - Country:US
Practice Address - Phone:201-316-7331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00845300367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q32505Medicare UPIN
R5C601Medicare ID - Type Unspecified