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NPI Code Detail

MEDICARE: MR. DANIEL HACKETT MCCARTY-PREFONTAINE PA-C

MEDICARE: MR. DANIEL HACKETT MCCARTY-PREFONTAINE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMA001756LPA

General Provider Information

NPI Number : 1093923492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL HACKETT MCCARTY-PREFONTAINE PA-C
Provider Business Mailing Address
First Line : 1412 FAIRMOUNT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-2908
Country : US
Telephone Number : 215-599-4851
Fax Number : 215-232-4093
Provider Business Practice Location Address
First Line : 1401 DEKALB ST
Second Line :
City : NORRISTOWN
State : PA
Zip : 19401-3405
Country : US
Telephone Number : 610-278-7787
Fax Number : 610-278-7386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 09/02/2021

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Directions to “ MR. DANIEL HACKETT MCCARTY-PREFONTAINE PA-C” Practice Location

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