Provider Demographics
NPI:1104493030
Name:MCCUE, DEIRDRE MARIE (RRT)
Entity type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:MARIE
Last Name:MCCUE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:MS
Other - First Name:DEIRDRE
Other - Middle Name:MARIE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1113
Mailing Address - Country:US
Mailing Address - Phone:781-335-6263
Mailing Address - Fax:
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA9392279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care