MEDICARE: EMMA MCCUE AU.D.

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
1	231H00000X	Audiologist	002716	NY

General Provider Information

NPI Number	:	1992228274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA MCCUE AU.D.

Provider Business Mailing Address
First Line	:	560 WHITE PLAINS ROAD
Second Line	:	SUITE 500
City	:	TARRYTOWN
State	:	NY
Zip	:	10591
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 TELEPORT DR STE 100
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10311-1007
Country	:	US
Telephone Number	:	718-370-0072
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	07/26/2017

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