1174551469 NPI number — MR. DARIN MCCARTHY MSPT

Table of content: MR. DARIN MCCARTHY MSPT (NPI 1174551469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174551469 NPI number — MR. DARIN MCCARTHY MSPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCARTHY
Provider First Name:
DARIN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174551469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
176 WALKER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01854-3126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-452-9252
Provider Business Mailing Address Fax Number:
978-970-0271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
176 WALKER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01854-3126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-452-9252
Provider Business Practice Location Address Fax Number:
978-970-0271
Provider Enumeration Date:
06/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  11098 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 23259 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Y68398 . This is a "BLUE CROSS PROVIDER #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 465533 . This is a "TUFTS PROVIDER #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 11532998 . This is a "CAQH #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2237829 . This is a "FIRST HEALTH (HCVM) #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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