Provider Demographics
NPI:1316463151
Name:MCCANN, STEPHEN H (C PED)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:H
Last Name:MCCANN
Suffix:
Gender:M
Credentials:C PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 EAST RD.
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473
Mailing Address - Country:US
Mailing Address - Phone:978-874-0843
Mailing Address - Fax:978-874-0843
Practice Address - Street 1:23 EAST RD.
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473
Practice Address - Country:US
Practice Address - Phone:972-874-0843
Practice Address - Fax:978-874-0843
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CPED0429224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist