Healthcare Provider Details

I. General information

NPI: 1598757544
Provider Name (Legal Business Name): MEGAN MCCABE PNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 NORMANSKILL BLVD
DELMAR NY
12054-1335
US

IV. Provider business mailing address

4 NORMANSKILL BLVD
DELMAR NY
12054-1335
US

V. Phone/Fax

Practice location:
  • Phone: 518-478-9423
  • Fax: 518-439-7046
Mailing address:
  • Phone: 518-478-9423
  • Fax: 518-439-7046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF380184
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: