Provider Demographics
NPI:1760422489
Name:MCCABE, JOHNATHAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:B
Last Name:MCCABE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:BRANDT
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:731 ALEXANDER RD
Mailing Address - Street 2:202
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6345
Mailing Address - Country:US
Mailing Address - Phone:609-921-7456
Mailing Address - Fax:609-921-2972
Practice Address - Street 1:731 ALEXANDER RD
Practice Address - Street 2:202
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6345
Practice Address - Country:US
Practice Address - Phone:609-921-7456
Practice Address - Fax:609-921-2972
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA47835174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ500205OtherAMERIHEALTH PPO
NJ931941OtherAETNA
NJ060013829OtherRAILROAD MEDICARE
NJ5075009Medicaid
NJF10828OtherHEALTHNET
NJ108808000OtherAMERIHEALTH HMO
NJP711893OtherOXFORD
F10828OtherADVANTAGE PLATINUM
NJ1462825OtherUNITED HEALTHCARE
NJ3025288026OtherCIGNA
F10828OtherGURADIAN
NJ3025288026OtherCIGNA
NJF10828OtherHEALTHNET
NJ931941OtherAETNA