Provider Demographics
NPI:1124216999
Name:MCCOY, CATHERINE J (MS APRN BC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:J
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MS APRN BC
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Other - Credentials:
Mailing Address - Street 1:400 SUNRISE HIGHWAY
Mailing Address - Street 2:ADOLESCENT PARTIAL PROGRAM OF SOUTH OAKS HOSPITAL WILSE
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701
Mailing Address - Country:US
Mailing Address - Phone:631-608-5341
Mailing Address - Fax:631-393-8743
Practice Address - Street 1:400 SUNRISE HIGHWAY
Practice Address - Street 2:ADOLESCENT PARTIAL PROGRAM OF SOUTH OAKS HOSPITAL WILSE
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-608-5341
Practice Address - Fax:631-393-8743
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282435163W00000X
NYF4000571363LP0808X
NY023050602ANCC364SP0807X
NY021538901ANCC364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult