Provider Demographics
NPI:1568552016
Name:SMITH, MCCARTHY GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:MCCARTHY
Middle Name:GEORGE
Last Name:SMITH
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 1:26 PONDFIELD ROAD WEST
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708
Mailing Address - Country:US
Mailing Address - Phone:914-961-1212
Mailing Address - Fax:914-663-5190
Practice Address - Street 1:26 PONDFIELD RD W
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2659
Practice Address - Country:US
Practice Address - Phone:914-961-1212
Practice Address - Fax:914-663-5190
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166361-6174400000X
NY166361208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01033283Medicaid
NY01033283Medicaid
NYB80159Medicare UPIN