Provider Demographics
NPI:1902182702
Name:MCCARTHY, SUZANNE M (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 N ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1601
Mailing Address - Country:US
Mailing Address - Phone:518-475-6730
Mailing Address - Fax:518-475-6729
Practice Address - Street 1:41 N ALLEN ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1601
Practice Address - Country:US
Practice Address - Phone:518-475-6730
Practice Address - Fax:518-475-6729
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY506827372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider