Provider Demographics
NPI:1871119578
Name:MCCARTHY, JOHN A (LAC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3662
Mailing Address - Country:US
Mailing Address - Phone:717-897-7801
Mailing Address - Fax:
Practice Address - Street 1:91 NEWPORT RD STE 302
Practice Address - Street 2:
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9579
Practice Address - Country:US
Practice Address - Phone:717-897-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001310171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist