Provider Demographics
NPI:1174512743
Name:MCCARTHY, FE TERESA (MD)
Entity type:Individual
Prefix:DR
First Name:FE TERESA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FE TERESA
Other - Middle Name:
Other - Last Name:DE JESUS-MCCARTHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:951 ALBANY SHAKER RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1409
Mailing Address - Country:US
Mailing Address - Phone:518-220-2022
Mailing Address - Fax:518-220-9263
Practice Address - Street 1:951 ALBANY SHAKER RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1409
Practice Address - Country:US
Practice Address - Phone:518-220-2022
Practice Address - Fax:518-220-9263
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117422174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00040458801OtherUNIVERA
NY50E762OtherEMPIRE B/C B/S
NYTMC231123OtherBLUE SHIELD CENTRAL NY
NY000416181001OtherBLUE SHIELD NENY
NY10001326OtherCDPHP
NY1308176OtherUNITED HEALTHCARE
NY5356307OtherAETNA
NYDC4198OtherRAILROAD MEDICARE
NY000000011263OtherGHI
NY00715733Medicaid
NY15128OtherMVP
NY5356307OtherAETNA
NY1308176OtherUNITED HEALTHCARE