Provider Demographics
NPI:1174419576
Name:MCGUCKIN, SAMUEL PATRICK (ATC)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:PATRICK
Last Name:MCGUCKIN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2006
Mailing Address - Country:US
Mailing Address - Phone:302-588-1027
Mailing Address - Fax:
Practice Address - Street 1:500 S MUDDY CREEK RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:PA
Practice Address - Zip Code:17517-9774
Practice Address - Country:US
Practice Address - Phone:717-335-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer