Basic Information
Provider Information
NPI: 1356758924
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGRATH
FirstName: JOANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MCGRATH
OtherFirstName: JOANNA
OtherMiddleName:  
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: CNM
OtherLastNameType: 2
Mailing Information
Address1: 227 LAUREL RD
Address2: STE 300
City: VOORHEES
State: NJ
PostalCode: 080438303
CountryCode: US
TelephoneNumber: 8566696025
FaxNumber: 8566510794
Practice Location
Address1: 599 SHORE RD
Address2: STE 101
City: SOMERS POINT
State: NJ
PostalCode: 082442400
CountryCode: US
TelephoneNumber: 8562628300
FaxNumber: 8562621635
Other Information
ProviderEnumerationDate: 07/16/2014
LastUpdateDate: 07/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
176B00000X25ME00055800NJY Other Service ProvidersMidwife 

No ID Information.


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