Doctor Name: | CHRIS MCCARTHY |
NPI Number: | 1083036446 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 003170 |
Business Practice Address: | 31 Main Rd Ste 2 Riverhead, NY - 119011953 |
Business Phone Number: | 6313698539 |
Business Fax Number: | |
Mailing Address: | 31 Main Rd Ste 2, RIVERHEAD |
State: | NY |
Postal Code: | 119011953 |
Phone Number: | 6313698539 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2014 |
NPI Last Update Date: | 01/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 003170 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |