Provider Demographics
NPI:1114044641
Name:MCCANN, JAMES EDWARD JR (MSC AUD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:MCCANN
Suffix:JR
Gender:M
Credentials:MSC AUD
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Mailing Address - Street 1:1395 ATWOOD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-4929
Mailing Address - Country:US
Mailing Address - Phone:401-946-4660
Mailing Address - Fax:401-946-0020
Practice Address - Street 1:1395 ATWOOD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-4929
Practice Address - Country:US
Practice Address - Phone:401-946-4660
Practice Address - Fax:401-946-0020
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI114231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI649007256Medicare PIN