Provider Demographics
NPI:1205060605
Name:MCCARTHY, ANGELA JUNG (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:JUNG
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:632 BROADWAY PH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2614
Mailing Address - Country:US
Mailing Address - Phone:800-731-4254
Mailing Address - Fax:
Practice Address - Street 1:632 BROADWAY PH
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2614
Practice Address - Country:US
Practice Address - Phone:800-731-4254
Practice Address - Fax:808-263-5016
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251017207R00000X
DCMD039839207R00000X
MDD74114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine