Provider Demographics
NPI:1932204401
Name:MCCARTHY, MARK PATRICK (ATC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:PATRICK
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:39 WOLCOTT WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1427
Mailing Address - Country:US
Mailing Address - Phone:860-674-0609
Mailing Address - Fax:860-674-8111
Practice Address - Street 1:100 SIMSBURY RD STE 208
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3793
Practice Address - Country:US
Practice Address - Phone:860-674-0609
Practice Address - Fax:860-674-8111
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer