Provider Demographics
NPI:1063730562
Name:MCCABE, DIANE P (PAC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:P
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1573
Mailing Address - Country:US
Mailing Address - Phone:215-529-9240
Mailing Address - Fax:215-529-9284
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-529-9240
Practice Address - Fax:215-529-9284
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA054322363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical