Healthcare Provider Details

I. General information

NPI: 1386730372
Provider Name (Legal Business Name): MARGARET MCCARTHY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E 155TH ST
BRONX NY
10455-1205
US

IV. Provider business mailing address

192 CHITTENDEN AVE
TUCKAHOE NY
10707-1627
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-9705
  • Fax:
Mailing address:
  • Phone: 914-779-1453
  • Fax: 401-652-9787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number330995
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number330995
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: