Provider Demographics
NPI:1316534084
Name:MCCUTCHEN, CASSIDY
Entity Type:Individual
Prefix:MRS
First Name:CASSIDY
Middle Name:
Last Name:MCCUTCHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1966 HYNDMAN RD
Mailing Address - Street 2:
Mailing Address - City:HYNDMAN
Mailing Address - State:PA
Mailing Address - Zip Code:15545-7734
Mailing Address - Country:US
Mailing Address - Phone:301-697-8912
Mailing Address - Fax:
Practice Address - Street 1:1966 HYNDMAN RD
Practice Address - Street 2:
Practice Address - City:HYNDMAN
Practice Address - State:PA
Practice Address - Zip Code:15545-7734
Practice Address - Country:US
Practice Address - Phone:301-697-8912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant