Doctor Name: | PATRICIA MCCORMACK |
NPI Number: | 1023049962 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00030700 |
Business Practice Address: | 6010 Black Horse Pike Egg Harbor Twp, NJ - 082349752 |
Business Phone Number: | 6092728580 |
Business Fax Number: | |
Mailing Address: | Po Box 1086, PLEASANTVILLE |
State: | NJ |
Postal Code: | 082326086 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 03/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 26NJ00030700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |