MEDICARE: DR. ROBERT OWEN MCCABE DPM

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	213E00000X	Podiatrist	3418	NY

General Provider Information

NPI Number	:	1972596104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT OWEN MCCABE DPM

Provider Business Mailing Address
First Line	:	124 SARATOGA RD
Second Line	:
City	:	SCOTIA
State	:	NY
Zip	:	12302
Country	:	US
Telephone Number	:	518-399-7782
Fax Number	:	518-399-7783

Provider Business Practice Location Address
First Line	:	124 SARATOGA RD
Second Line	:
City	:	SCOTIA
State	:	NY
Zip	:	12302
Country	:	US
Telephone Number	:	518-399-7782
Fax Number	:	518-399-7783

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	08/31/2011

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