Individual
SAMANTHA MARIE MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6096
Mailing address
168 COEYMAN AVE, NUTLEY, NJ 07110-1503
(973) 930-8655
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ14955300
NJ
Other
Enumeration date
12/06/2023
Last updated
10/15/2024
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