Provider Demographics
NPI:1871019851
Name:MCCABE, LOUIS (ABC CPO)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:MCCABE
Suffix:
Gender:M
Credentials:ABC CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 E JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7317
Mailing Address - Country:US
Mailing Address - Phone:631-271-0825
Mailing Address - Fax:631-271-1363
Practice Address - Street 1:616 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7317
Practice Address - Country:US
Practice Address - Phone:631-271-0825
Practice Address - Fax:631-271-1363
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224P00000X
NY224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist