Provider Demographics
NPI:1215411871
Name:MCARTHUR, BETHMARIE NICOLE
Entity Type:Individual
Prefix:
First Name:BETHMARIE
Middle Name:NICOLE
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11523 145TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11436-1142
Mailing Address - Country:US
Mailing Address - Phone:347-665-6137
Mailing Address - Fax:
Practice Address - Street 1:11523 145TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11436-1142
Practice Address - Country:US
Practice Address - Phone:347-665-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency