MEDICARE: GINA M MCCANN

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	174400000X	Specialist

General Provider Information

NPI Number	:	1861344699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA M MCCANN

Provider Business Mailing Address
First Line	:	804 ROUTE 211 W
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-7570
Country	:	US
Telephone Number	:	845-519-7935
Fax Number	:

Provider Business Practice Location Address
First Line	:	804 ROUTE 211 W
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-7570
Country	:	US
Telephone Number	:	845-519-7935
Fax Number	:

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

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “ GINA M MCCANN ” Practice Location

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