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General NPI Number Information
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NPI Number | 1023764487
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Entity Type | Individual
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Provider Name | MICHAELA DUFFY MCCARGAR FNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 19472 US-11 SUITE N 101
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City | WATERTOWN
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State | NY
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Zip | 13601
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Country | US
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Telephone | 315-786-1924
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Fax |
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Provider Business Mailing Address
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Address Line | 23663 COUNTY ROUTE 59
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City | DEXTER
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State | NY
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Zip | 13634-2075
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Country | US
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Telephone | 315-836-5162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F349048
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License Number State | NY
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