Provider Demographics
NPI:1407658883
Name:MCFADDEN, MAEVE (ATC)
Entity type:Individual
Prefix:
First Name:MAEVE
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2495 HERBERT DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1401
Mailing Address - Country:US
Mailing Address - Phone:609-204-8842
Mailing Address - Fax:
Practice Address - Street 1:2495 HERBERT DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1401
Practice Address - Country:US
Practice Address - Phone:609-204-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT003322002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer