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NPI Code Detail

MEDICARE: MS. MARY E MCCUE R.D., C.D.N.

MEDICARE: MS. MARY E MCCUE R.D., C.D.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian48 005778NY

General Provider Information

NPI Number : 1255799243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY E MCCUE R.D., C.D.N.
Provider Business Mailing Address
First Line : 15 DUNN AVE
Second Line :
City : CORINTH
State : NY
Zip : 12822-1031
Country : US
Telephone Number : 518-257-6530
Fax Number : 518-257-6530
Provider Business Practice Location Address
First Line : 58 HENRY ST
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-3232
Country : US
Telephone Number : 518-257-6530
Fax Number : 518-632-7711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2016
Last Update Date : 07/08/2021

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