Provider Demographics
NPI:1285624379
Name:MCCORMICK, NANCY E (PT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:41 ARTERIAL PLZ
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-2512
Mailing Address - Country:US
Mailing Address - Phone:518-775-9554
Mailing Address - Fax:518-773-7747
Practice Address - Street 1:215 COUNTY HIGHWAY 128
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-4806
Practice Address - Country:US
Practice Address - Phone:518-773-2508
Practice Address - Fax:518-773-8511
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2020-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0114421208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00527239Medicaid
NY000581300OtherBC UTICA
NY000492126001OtherBSN ENLY