Provider Demographics
NPI:1083261911
Name:MCCARTHY, MEGAN C (ACAGNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:ACAGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PINEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-6861
Mailing Address - Country:US
Mailing Address - Phone:908-392-6860
Mailing Address - Fax:
Practice Address - Street 1:18 PINEWOOD LN
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-6861
Practice Address - Country:US
Practice Address - Phone:908-392-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431582363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care