Provider Demographics
NPI:1922472463
Name:MCCARTHY, JUDITH A (LMT, CPMT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LMT, CPMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WILLIAMSON AVE
Mailing Address - Street 2:
Mailing Address - City:FALLSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19054-1114
Mailing Address - Country:US
Mailing Address - Phone:215-428-3898
Mailing Address - Fax:
Practice Address - Street 1:33 WILLIAMSON AVE
Practice Address - Street 2:
Practice Address - City:FALLSINGTON
Practice Address - State:PA
Practice Address - Zip Code:19054-1114
Practice Address - Country:US
Practice Address - Phone:215-428-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG007247174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist