Healthcare Provider Details

I. General information

NPI: 1699236851
Provider Name (Legal Business Name): MOIRA ELAINE MCCARTHY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

IV. Provider business mailing address

2500 MARYLAND RD STE 400
WILLOW GROVE PA
19090-1225
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-6784
  • Fax: 215-481-3611
Mailing address:
  • Phone: 215-481-4143
  • Fax: 215-481-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP020074
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP020074
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: