Provider Demographics
NPI:1952718413
Name:MCCARTHY, HOLLY KNIGHT (OD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:KNIGHT
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:15 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2726
Mailing Address - Country:US
Mailing Address - Phone:207-774-8277
Mailing Address - Fax:207-699-5850
Practice Address - Street 1:15 LOWELL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2726
Practice Address - Country:US
Practice Address - Phone:207-774-8277
Practice Address - Fax:207-699-5850
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002902152W00000X
MEOPT959152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist