Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2279121 | NY |
NPI | 1043290687 |
---|---|
Provider Name | William E Mccormick |
First Address | West Islip, NY 11795-4403 |
Second Address | West Islip, NY 11795-4403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 20/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02478417 | (05) | NY |
P00198803 | MEDICARE RR (01) | NY |