Individual
JENNIFER MCCORMAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP, CWON
Contact information
Practice address
1315 YORK AVE FL 2, NEW YORK, NY 10021-5304
(646) 962-2270
(212) 746-6370
Mailing address
2921 BELLPORT AVE, WANTAGH, NY 11793-4511
(631) 946-2558
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
632605-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F308845-1
NY
Other
Enumeration date
09/08/2018
Last updated
06/03/2025
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