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General NPI Number Information
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NPI Number | 1235103342
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Entity Type | Individual
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Provider Name | JOHN DOMINICK MCCARTHY D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 1776 RICHMOND RD SUITE 5
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2581
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Country | US
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Telephone | 718-668-9300
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Fax | 718-668-1834
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Provider Business Mailing Address
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Address Line | 3000 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-4106
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Country | US
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Telephone | 718-668-9300
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Fax | 718-668-1834
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 211722
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License Number State | NY
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