MEDICARE: MR. MCCARTHY HANGER CP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224P00000X	Prosthetist	3843	NY

General Provider Information

NPI Number	:	1174092589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MCCARTHY HANGER CP

Provider Business Mailing Address
First Line	:	215 E 73RD ST UNIT 1B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3653
Country	:	US
Telephone Number	:	917-647-2540
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 E 73RD ST UNIT 1B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3653
Country	:	US
Telephone Number	:	917-647-2540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2018
Last Update Date	:	11/14/2018

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