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NPI Code Detail

MEDICARE: MR. TIMOTHY P MCCUE BC-HIS

MEDICARE: MR. TIMOTHY P MCCUE BC-HIS
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
1237700000XHearing Instrument Specialist14000010636NY

General Provider Information

NPI Number : 1376879213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY P MCCUE BC-HIS
Provider Business Mailing Address
First Line : 1100 CLEMENS CENTER PKWY
Second Line :
City : ELMIRA
State : NY
Zip : 14901-1563
Country : US
Telephone Number : 607-733-4783
Fax Number : 607-733-6037
Provider Business Practice Location Address
First Line : 1100 CLEMENS CENTER PKWY
Second Line :
City : ELMIRA
State : NY
Zip : 14901-1563
Country : US
Telephone Number : 607-733-4783
Fax Number : 607-733-6037
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2009
Last Update Date : 08/11/2010

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