Provider Demographics
NPI:1386847341
Name:MCCARTHY, CRAIG M (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:M
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:917-608-4506
Mailing Address - Fax:
Practice Address - Street 1:144 W 12TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:917-608-4506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ276492084P0800X
NY1957482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3471721241OtherPTAN
AZG18763Medicare UPIN