Provider Demographics
NPI:1891421301
Name:MCCORMICK PSYCHIATRIC ASSOCIATES
Entity type:Organization
Organization Name:MCCORMICK PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:LOUBRIEL TORRES
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-767-7371
Mailing Address - Street 1:3 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKLEIGH
Mailing Address - State:NJ
Mailing Address - Zip Code:07647-2707
Mailing Address - Country:US
Mailing Address - Phone:352-727-8788
Mailing Address - Fax:
Practice Address - Street 1:300 CENTRAL PARK W
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1590
Practice Address - Country:US
Practice Address - Phone:212-767-7371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA11438700OtherMEDICAL LICENSE
NY291142OtherMEDICAL LICENSE