MEDICARE: DR. MATTHEW EDWARD MCCABE I D.C.

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	111N00000X	Chiropractor	CH11653	FL

General Provider Information

NPI Number	:	1003289513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW EDWARD MCCABE I D.C.

Provider Business Mailing Address
First Line	:	23 STIRRUP DR
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-2309
Country	:	US
Telephone Number	:	518-365-5817
Fax Number	:

Provider Business Practice Location Address
First Line	:	10491 6 MILE CYPRESS PKWY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-6406
Country	:	US
Telephone Number	:	239-288-5876
Fax Number	:

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

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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