| Doctor Name: | MARY MCCORMACK |
| NPI Number: | 1225169121 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN-C,FNP, MPH |
| License Number: | 26NN08959300 |
| Business Practice Address: | 84 Cold Hill Rd Mendham, NJ - 079452021 |
| Business Phone Number: | 9735432500 |
| Business Fax Number: | 9735434123 |
| Mailing Address: | 39 Maple St, CHATHAM |
| State: | NJ |
| Postal Code: | 079281914 |
| Phone Number: | 9737018262 |
| Fax Number: | |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26NN08959300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |