Healthcare Provider Details

I. General information

NPI: 1710809090
Provider Name (Legal Business Name): MARY MCARTOR OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 GRAHAM AVE
BROOKLYN NY
11206-3320
US

IV. Provider business mailing address

3807 34TH AVE
LONG ISLAND CITY NY
11101-1103
US

V. Phone/Fax

Practice location:
  • Phone: 718-690-2177
  • Fax:
Mailing address:
  • Phone: 302-241-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011449
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: