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Organization

MARY ELLEN MCCOY, DPM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARYELLEN MCCOY D.P.M. (DOCTOR)
(732) 350-7465
Entity
Organization

Contact information

Practice address
65-H LACEY ROAD, WHITING, NJ 08759
(732) 350-7465
(732) 350-7105
Mailing address
65-H LACEY ROAD, WHITING, NJ 08759
(732) 350-7465
(732) 350-7105

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD01747
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0102229000
AMERIHEALTH
NJ
05
0774901
NJ
Enumeration date
11/24/2006
Last updated
06/21/2018
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