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1962793521 NPI number — MATTHEW THOMAS MCCARTHY M.D.

NPI Number: 1962793521
Health Care Provider/Practitioner: MATTHEW THOMAS MCCARTHY M.D.

Information about “1962793521” NPI (MATTHEW THOMAS MCCARTHY M.D.) exists in 1962793521 in HTML format HTML  |  1962793521 in plain Text format TXT  |  1962793521 in PDF (Portable Document Format) PDF  |  1962793521 in an XML format XML  formats.

NPI Number : 1962793521 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962793521",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCCARTHY",
    "FirstName": "MATTHEW",
    "MiddleName": "THOMAS",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "140 PARK AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLORHAM PARK",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07932-1049",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "973-718-5800",
    "MailingAddressFaxNumber": "973-425-5512",
    "FirstLinePracticeLocationAddress": "140 PARK AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLORHAM PARK",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07932-1049",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "973-718-5800",
    "PracticeLocationAddressFaxNumber": "973-425-5512",
    "EnumerationDate": "04/29/2011",
    "LastUpdateDate": "07/22/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084N0402X",
          "TaxonomyName": "Neurology with Special Qualifications in Child Neurology Physician",
          "LicenseNumber": "4301109182",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084S0010X",
          "TaxonomyName": "Sports Medicine (Psychiatry & Neurology) Physician",
          "LicenseNumber": "25MA10493600",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084S0010X",
          "TaxonomyName": "Sports Medicine (Psychiatry & Neurology) Physician",
          "LicenseNumber": "4301109182",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084N0402X",
          "TaxonomyName": "Neurology with Special Qualifications in Child Neurology Physician",
          "LicenseNumber": "25MA10493600",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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