Provider Demographics
NPI:1093972978
Name:MCCARTHY, DANIEL LEO III (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEO
Last Name:MCCARTHY
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1169
Mailing Address - Country:US
Mailing Address - Phone:848-525-1637
Mailing Address - Fax:
Practice Address - Street 1:1880 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1169
Practice Address - Country:US
Practice Address - Phone:848-525-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMCO3314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor