Provider Demographics
NPI:1174609168
Name:MCCARTHY, BRIAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1419
Mailing Address - Country:US
Mailing Address - Phone:267-978-4782
Mailing Address - Fax:
Practice Address - Street 1:BEEBE MEDICAL CENTER
Practice Address - Street 2:424 SAVANNAH ROAD
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-0226
Practice Address - Country:US
Practice Address - Phone:302-645-3100
Practice Address - Fax:302-645-3632
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000558363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical