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NPI Code Detail

MEDICARE: DR. ROBERT B. MCCUE II PSY.D.

MEDICARE: DR. ROBERT B. MCCUE II PSY.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
1103G00000XClinical NeuropsychologistPY5358FL
2103G00000XClinical Neuropsychologist003233CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
159819YOTHERFLINDIVIDUAL
2003233OTHERCTCONNECTICUT PSYCHOLOGIST LICENSE

General Provider Information

NPI Number : 1497846216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT B. MCCUE II PSY.D.
Provider Business Mailing Address
First Line : 100 DEERFIELD RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-4252
Country : US
Telephone Number : 860-552-2002
Fax Number :
Provider Business Practice Location Address
First Line : 100 DEERFIELD RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-4252
Country : US
Telephone Number : 860-552-2002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 10/19/2012

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