Provider Demographics
NPI:1114339025
Name:MCCARTHY, THOMAS JAMES (CRNA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 POPLAR CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4323
Mailing Address - Country:US
Mailing Address - Phone:267-391-7976
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLAZA
Practice Address - Street 2:COOPER UNIVERSITY HOSPITAL
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16213100163WC0200X
PARN597575163WC0200X
PA102937367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine