Healthcare Provider Details

I. General information

NPI: 1225386980
Provider Name (Legal Business Name): KATHLEEN M MCCABE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 PICCARD DR STE 100
ROCKVILLE MD
20850-4317
US

IV. Provider business mailing address

1249 PARK AVE APT 8D
NEW YORK NY
10029-7211
US

V. Phone/Fax

Practice location:
  • Phone: 301-921-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License NumberH0084307
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: