1356758924 NPI number — JOANNA MCGRATH CNM

Table of content: JOANNA MCGRATH CNM (NPI 1356758924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356758924 NPI number — JOANNA MCGRATH CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGRATH
Provider First Name:
JOANNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCGRATH
Provider Other First Name:
JOANNA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1356758924
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 LAUREL RD
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-8303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-669-6025
Provider Business Mailing Address Fax Number:
856-651-0794

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
599 SHORE RD
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
SOMERS POINT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08244-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-262-8300
Provider Business Practice Location Address Fax Number:
856-262-1635
Provider Enumeration Date:
07/16/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  25ME00055800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0001X , with the licence number: 26285 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)