Provider Demographics
NPI:1982733671
Name:MCNALLY, MAUREEN MARY T (NP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MARY T
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:T
Other - Last Name:MCNALLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:245 HINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-1249
Mailing Address - Country:US
Mailing Address - Phone:781-871-1247
Mailing Address - Fax:
Practice Address - Street 1:30 WINTER ST FL 7
Practice Address - Street 2:COMMONWEALTH CARE ALLIANCE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4720
Practice Address - Country:US
Practice Address - Phone:617-426-0600
Practice Address - Fax:617-426-1311
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA198409363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily