Individual
KYLE MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 CELLINI PL STE 102, WEST HAVEN, CT 06516-1666
(203) 932-6481
(203) 932-4051
Mailing address
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-4740
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002598
CT
Other
Enumeration date
08/15/2011
Last updated
01/08/2024
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