Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 173828 | NY |
NPI | 1043293129 |
---|---|
Provider Name | Dr. Edward D Mccabe |
First Address | Staten Island, NY 10305-4900 |
Second Address | Staten Island, NY 10305-3408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 17/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01182498 | (05) | NY |
370017381 | RAILROAD MEDICARE (01) | NY |
E45068 | (02) | NY |