Provider Demographics
NPI:1720292378
Name:MCGREAL, MAUREEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:MCGREAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 RIDGEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-1141
Mailing Address - Country:US
Mailing Address - Phone:973-335-3695
Mailing Address - Fax:
Practice Address - Street 1:159 RIDGEVIEW PL
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1141
Practice Address - Country:US
Practice Address - Phone:973-335-3695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00199000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical