Provider Demographics
NPI:1710184247
Name:MCCARTHY, BRIDGET P (LPN)
Entity Type:Individual
Prefix:MISS
First Name:BRIDGET
Middle Name:P
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:P
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:801 BRONX RIVER ROAD
Mailing Address - Street 2:APT 5-J
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-8038
Mailing Address - Country:US
Mailing Address - Phone:914-776-5459
Mailing Address - Fax:
Practice Address - Street 1:35 WINDING WOOD RD N
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573
Practice Address - Country:US
Practice Address - Phone:914-937-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02064840Medicaid