Provider Demographics
NPI:1295801157
Name:MCCAIN, DONALD A (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A
Last Name:MCCAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:201-342-1010
Mailing Address - Fax:201-342-1030
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 603
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-342-1010
Practice Address - Fax:201-342-1030
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0679282086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7840705Medicaid
NJ7840705Medicaid
NJG78910Medicare UPIN