Healthcare Provider Details

I. General information

NPI: 1649993924
Provider Name (Legal Business Name): MARIE CATHERINE MCHENRY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE CATHERINE DUNLEAVY FNP

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E POST RD
WHITE PLAINS NY
10601-4607
US

IV. Provider business mailing address

14 CUMBERLAND DR
YONKERS NY
10704-3502
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-0600
  • Fax:
Mailing address:
  • Phone: 914-409-8719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350786
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: