Provider Demographics
NPI:1912899121
Name:MCWHIRTER, MICHAEL JOHN JR
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:MCWHIRTER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SUMMIT PL
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-2031
Mailing Address - Country:US
Mailing Address - Phone:631-566-0602
Mailing Address - Fax:
Practice Address - Street 1:12 SUMMIT PL
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-2031
Practice Address - Country:US
Practice Address - Phone:631-566-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY753201163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse