Provider Demographics
NPI:1427367986
Name:MCCARVILL, ELISE (PT)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:MCCARVILL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:LABAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:14 W GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1801
Mailing Address - Country:US
Mailing Address - Phone:845-735-2579
Mailing Address - Fax:
Practice Address - Street 1:14 W GEORGE AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1801
Practice Address - Country:US
Practice Address - Phone:845-735-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018635-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist