Provider Demographics
NPI:1730247909
Name:MCNAMARA, TARA M (OD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:M
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4000 VINE ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-3565
Mailing Address - Country:US
Mailing Address - Phone:717-944-9814
Mailing Address - Fax:717-944-9814
Practice Address - Street 1:4000 VINE ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-3565
Practice Address - Country:US
Practice Address - Phone:717-944-9814
Practice Address - Fax:717-944-9814
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1700X
PAOEG001416152WC0802X
NYTOO6072-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist