Provider Demographics
NPI:1134121296
Name:MCCABE, MARC NATHAN (RPA-C)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:NATHAN
Last Name:MCCABE
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:30 N UNION RD
Mailing Address - Street 2:STE 104
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5367
Mailing Address - Country:US
Mailing Address - Phone:716-565-3990
Mailing Address - Fax:716-565-3988
Practice Address - Street 1:30 N UNION RD
Practice Address - Street 2:STE 104
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5367
Practice Address - Country:US
Practice Address - Phone:716-565-3990
Practice Address - Fax:716-565-3988
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2011-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY069671363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS90028Medicare UPIN