Provider Demographics
NPI:1598757544
Name:MCCABE, MEGAN (PNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NORMANSKILL BLVD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1335
Mailing Address - Country:US
Mailing Address - Phone:518-478-9423
Mailing Address - Fax:518-439-7046
Practice Address - Street 1:4 NORMANSKILL BLVD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1335
Practice Address - Country:US
Practice Address - Phone:518-478-9423
Practice Address - Fax:518-439-7046
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380184363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS53278Medicare UPIN
NYRA5190Medicare PIN