Provider Demographics
NPI:1295227924
Name:MCCARTHY, VALERIE (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:KYSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:61 DELANO ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:NY
Mailing Address - Zip Code:13142-1400
Mailing Address - Country:US
Mailing Address - Phone:315-298-6569
Mailing Address - Fax:315-298-7488
Practice Address - Street 1:10 GEORGE ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-3276
Practice Address - Country:US
Practice Address - Phone:315-342-0880
Practice Address - Fax:315-593-6195
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEEC181040390200000X
NY310695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program