Provider Demographics
NPI:1710934187
Name:MCCABE, EVIN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:EVIN
Middle Name:JOSEPH
Last Name:MCCABE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:305 2ND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2746
Mailing Address - Country:US
Mailing Address - Phone:212-734-8874
Mailing Address - Fax:212-249-5628
Practice Address - Street 1:305 2ND AVE STE 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2746
Practice Address - Country:US
Practice Address - Phone:212-734-8874
Practice Address - Fax:212-249-5628
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226857-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWZVZP1Medicare PIN
NY2243S1Medicare UPIN