Provider Demographics
NPI:1174891238
Name:MCNAMARA, KEELEY RYAN (CNM)
Entity type:Individual
Prefix:
First Name:KEELEY
Middle Name:RYAN
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 14TH ST APT 14A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4660
Mailing Address - Country:US
Mailing Address - Phone:646-526-6397
Mailing Address - Fax:
Practice Address - Street 1:1980 CROMPOND RD STE 212
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:914-736-6180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001459-1176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife