Provider Demographics
NPI:1528206620
Name:MCCUEN & ASSOCIATES PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:MCCUEN & ASSOCIATES PHYSICAL THERAPY, P.C.
Other - Org Name:FIRST CHOICE REHABILITATION SPECIALISTS, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:S
Authorized Official - Last Name:BASOM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:717-737-9818
Mailing Address - Street 1:4033 LINGLESTOWN ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1153
Mailing Address - Country:US
Mailing Address - Phone:717-920-5002
Mailing Address - Fax:707-920-5224
Practice Address - Street 1:4033 LINGLESTOWN ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1153
Practice Address - Country:US
Practice Address - Phone:717-920-5002
Practice Address - Fax:707-920-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5082380003Medicare PIN