Individual
NICOLE MARIE MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4045 HEMPSTEAD TPKE FL 3, BETHPAGE, NY 11714-5611
(516) 731-7770
(516) 541-1721
Mailing address
4045 HEMPSTEAD TPKE FL 3, BETHPAGE, NY 11714-5611
(516) 731-7770
(516) 541-1721
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0010-00180
NC
363AM0700X
Medical Physician Assistant
Primary
008886-1
NY
Other
Enumeration date
07/21/2006
Last updated
03/10/2022
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