Healthcare Provider Details

I. General information

NPI: 1437189719
Provider Name (Legal Business Name): ABBY MCCARTHY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/07/2023
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

1000 SOUTH AVE EMERGENCY DEPARTMENT
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-1632
  • Fax:
Mailing address:
  • Phone: 585-314-7479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number008869
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8869
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: