Provider Demographics
NPI:1366965774
Name:MCGORMAN, CHRISTY (PA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:
Last Name:MCGORMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:SIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:100 EAST 77TH. ST.
Mailing Address - Street 2:LENOX HILL EMERGENCY DEPARTMENT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075
Mailing Address - Country:US
Mailing Address - Phone:212-434-3042
Mailing Address - Fax:
Practice Address - Street 1:100 EAST 77TH. ST.
Practice Address - Street 2:LENOX HILL EMERGENCY DEPARTMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075
Practice Address - Country:US
Practice Address - Phone:212-434-3042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021054363AM0700X
VA0110008563363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant