Provider Demographics
NPI:1215012521
Name:MCCABE, PATRICIA ANN (PNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LANTERN LN
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9321
Mailing Address - Country:US
Mailing Address - Phone:585-255-0685
Mailing Address - Fax:
Practice Address - Street 1:1850 BUFFALO RD
Practice Address - Street 2:SUITE 200 GENESIS PEDIATRICS
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1502
Practice Address - Country:US
Practice Address - Phone:585-426-4100
Practice Address - Fax:585-426-3701
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380023363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01725OtherBLUE SHIELD OF ROCHESTER
NY384748OtherMVP UPSTATE DHP
NY01907831Medicaid
4334391OtherAETNA US HEALTHCARE
RC60164923OtherPOMCO
Y028938OtherTRICARE REGION 1
NYNP0020OtherPREFERRED CARE