Provider Demographics
NPI:1841468089
Name:MCCARTHY, PRISCILLA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 LAKESIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:07850-1109
Mailing Address - Country:US
Mailing Address - Phone:973-398-3303
Mailing Address - Fax:973-398-5751
Practice Address - Street 1:175 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:LANDING
Practice Address - State:NJ
Practice Address - Zip Code:07850-1109
Practice Address - Country:US
Practice Address - Phone:973-398-3303
Practice Address - Fax:973-398-5751
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02758200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist