Doctor Name: | MR. SEAN MORGAN HERMICK |
NPI Number: | 1154401784 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 900 Washington Rd Credentential's Office, Keller Army Community Hospital West Point, NY - 109961109 |
Business Phone Number: | 8459384733 |
Business Fax Number: | |
Mailing Address: | 900 Washington Rd, Credentential's Office, Keller Army Community Hospital WEST POINT |
State: | NY |
Postal Code: | 109961109 |
Phone Number: | 8459384733 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |