Provider Demographics
NPI:1649730268
Name:MCCABE, EMMA ISHTA (CBC)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ISHTA
Last Name:MCCABE
Suffix:
Gender:F
Credentials:CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 PRESIDENT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4905
Mailing Address - Country:US
Mailing Address - Phone:347-703-7851
Mailing Address - Fax:
Practice Address - Street 1:299 PRESIDENT ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4905
Practice Address - Country:US
Practice Address - Phone:347-703-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20180410174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN