Provider Demographics
NPI:1346013174
Name:MCCARTHY, GRACE (NYS LMT, FL LMT)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:NYS LMT, FL LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-3313
Mailing Address - Country:US
Mailing Address - Phone:631-766-6156
Mailing Address - Fax:
Practice Address - Street 1:41 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2323
Practice Address - Country:US
Practice Address - Phone:631-288-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01439101225700000X
NY014391225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist