Provider Demographics
NPI:1023084407
Name:MCCARTHY, SUSAN W (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:W
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MERRICK RD STE 102E
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4832
Mailing Address - Country:US
Mailing Address - Phone:516-277-2060
Mailing Address - Fax:516-277-2058
Practice Address - Street 1:100 MERRICK RD STE 102E
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4832
Practice Address - Country:US
Practice Address - Phone:516-277-2060
Practice Address - Fax:516-277-2058
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175055208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics