Provider Demographics
NPI:1235302316
Name:MCNAMARA, MARIA R (RD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:R
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2667
Mailing Address - Country:US
Mailing Address - Phone:860-916-3676
Mailing Address - Fax:
Practice Address - Street 1:1245 FARMINGTON AVE PMB 1277
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4240
Practice Address - Country:US
Practice Address - Phone:860-916-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000812133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered