Provider Demographics
NPI:1043291354
Name:MCCARTHY, PATRICK MICHAEL (PT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2 DELAVERGNE AVE
Mailing Address - Street 2:C/O CENTER FOR PHYSICAL THERAPY
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-1202
Mailing Address - Country:US
Mailing Address - Phone:845-297-4789
Mailing Address - Fax:845-297-8596
Practice Address - Street 1:2 DELAVERGNE AVE
Practice Address - Street 2:C/O CENTER FOR PHYSICAL THERAPY
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1202
Practice Address - Country:US
Practice Address - Phone:845-297-4789
Practice Address - Fax:845-297-8596
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10086295OtherCDPHP
83631OtherMANAGED PHYSICAL NETWORK
99464OtherOPERATING ENGNRS LCL 825
NYQ04U11OtherBLUE CROSS BLUE SHIELD
2164963OtherCCN
410057OtherMVP
P2978579OtherOXFORD
000409360001OtherHEALTH NOW
7215486OtherAETNA PPO
2356844OtherUNITED HEALTH CARE
3320327OtherAETNA HMO
NYQ04U11Medicare ID - Type UnspecifiedMEDICARE