Provider Demographics
NPI:1063448025
Name:MCCARTHY, BRIAN WJ (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WJ
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1407 W 6TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4802
Mailing Address - Country:US
Mailing Address - Phone:718-256-1057
Mailing Address - Fax:718-256-4912
Practice Address - Street 1:4982 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6399
Practice Address - Country:US
Practice Address - Phone:718-967-6200
Practice Address - Fax:718-967-6314
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY208767208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics