Provider Demographics
NPI:1063756351
Name:MCGARRITY, MARK (BCBA)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:MCGARRITY
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1042
Mailing Address - Street 2:
Mailing Address - City:PORT EWEN
Mailing Address - State:NY
Mailing Address - Zip Code:12466-1042
Mailing Address - Country:US
Mailing Address - Phone:845-331-4711
Mailing Address - Fax:
Practice Address - Street 1:40 DEVEREUX WAY
Practice Address - Street 2:
Practice Address - City:REDHOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-0040
Practice Address - Country:US
Practice Address - Phone:845-758-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1107459103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst