MEDICARE: DR. MARIA A CUDDY-CASEY 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	103TC0700X	Clinical Psychologist	PS008837L	PA

General Provider Information

NPI Number	:	1962732198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA A CUDDY-CASEY PHD

Provider Business Mailing Address
First Line	:	1113 WINDSOR DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4012
Country	:	US
Telephone Number	:	484-678-4697
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 W CHESTER PIKE STE 2
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5646
Country	:	US
Telephone Number	:	484-301-2304
Fax Number	:

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

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	05/11/2020

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