MEDICARE: MICHAEL MCCUE PHD

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	103G00000X	Clinical Neuropsychologist	PS 3981-L	PA
2	103TC0700X	Clinical Psychologist	PS 3981-L	PA
3	103TR0400X	Rehabilitation Psychologist	PS 3981-L	PA

General Provider Information

NPI Number	:	1730546730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MCCUE PHD

Provider Business Mailing Address
First Line	:	1501 REEDSDALE ST
Second Line	:	SUITE 204
City	:	PITTSBURGH
State	:	PA
Zip	:	15233-2341
Country	:	US
Telephone Number	:	412-501-3080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 REEDSDALE ST
Second Line	:	SUITE 204
City	:	PITTSBURGH
State	:	PA
Zip	:	15233-2341
Country	:	US
Telephone Number	:	412-501-3080
Fax Number	:

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

Provider Enumeration Date	:	01/21/2016
Last Update Date	:	01/21/2016

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