Individual
NICOLE SUZANNE MCCARTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
392 SEGUINE AVE, STATEN ISLAND, NY 10309-3906
(718) 226-2622
Mailing address
392 SEGUINE AVE, STATEN ISLAND, NY 10309-3906
(718) 226-2622
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPA-1880
NY
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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