Provider Demographics
NPI:1538255377
Name:MCCARTHY, LISA ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:19 PARK HILL TER
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3048
Mailing Address - Country:US
Mailing Address - Phone:845-621-9799
Mailing Address - Fax:
Practice Address - Street 1:667 STONELEIGH AVE STE 111
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2455
Practice Address - Country:US
Practice Address - Phone:845-279-9652
Practice Address - Fax:845-279-3606
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF381445363LP0200X
NY381445363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics