Provider Demographics
NPI:1154467462
Name:FE TERESA J. MCCARTHY, MD
Entity Type:Organization
Organization Name:FE TERESA J. MCCARTHY, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-220-2022
Mailing Address - Street 1:951 ALBANY SHAKER RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1409
Mailing Address - Country:US
Mailing Address - Phone:518-220-2022
Mailing Address - Fax:518-220-9263
Practice Address - Street 1:951 ALBANY SHAKER RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1409
Practice Address - Country:US
Practice Address - Phone:518-220-2022
Practice Address - Fax:518-220-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117422174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55813AMedicare ID - Type UnspecifiedGROUP ID NUMBER