MEDICARE: KARI MCCAA

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	164W00000X	Licensed Practical Nurse	264878-01	NY

General Provider Information

NPI Number	:	1568397008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI MCCAA

Provider Business Mailing Address
First Line	:	PO BOX 137
Second Line	:
City	:	CUBA
State	:	NY
Zip	:	14727-0137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 STATE ROUTE 417 W
Second Line	:
City	:	WELLSVILLE
State	:	NY
Zip	:	14895-9332
Country	:	US
Telephone Number	:	585-593-6300
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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