Provider Demographics
NPI:1225242290
Name:MCCARTHY, LOUISE ANNE (CPNP)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:ANNE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BEACH 217 STREET
Mailing Address - Street 2:
Mailing Address - City:BREEZY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11697
Mailing Address - Country:US
Mailing Address - Phone:718-634-0021
Mailing Address - Fax:
Practice Address - Street 1:557 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-5727
Practice Address - Country:US
Practice Address - Phone:718-240-2700
Practice Address - Fax:718-485-9517
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380038363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics