MR. DWAYNE K MCCORMICK SR. (NPI# 1235690702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235690702 |
| Entity Type | Individual |
| Full Name | MR. DWAYNE K MCCORMICK SR. |
| Credential | CERTIFIED HAIR LOSS |
| Practice Address |
542 Bloy St Hillside NJ 07205-1744 |
| Mailing Address |
1105 Joseph Ct South Plainfield NJ 07080-2354 |
| Practice Telephone | 9732776354 |
| Mailing Telephone | 9732776354 |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
32WG07436100 | NJ | Other Service Providers |
| Street Address |
542 BLOY ST |
| City | HILLSIDE |
| State | NJ |
| Zip Code | 07205-1744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604618 | Adrienne Garro | Psychologist | Kean University East Campus 215 North Avenue, Dept. of Advanced Studies In Psychology East Campus, Hillside, NJ 07205 | 2018-03-26 |
| 1821347360 | Esther N Lieberman | Specialist | 28 King Street, Hillside, NJ 07205 | 2012-08-30 |
| 1346430089 | On Call Ambulance, LLC | Ambulance | 431 Hillside Ave, Hillside, NJ 07205 | 2007-07-30 |
| 1558551481 | Kona K3 Medical Supplies | Durable Medical Equipment & Medical Supplies | 146 Hillside Avenue, Hillside, NJ 07205 | 2007-07-26 |
| 1154532075 | Hillside Twp. Publlic School | Local Education Agency (LEA) | Hillside High School - Dept of Special Services, 1085 Liberty Ave., Hillside, NJ 07205 | 2007-05-24 |
| 1881778470 | New Jersey Cvs Pharmacy LLC | Pharmacy | 265 Long Ave Shop Rite Sc, Hillside, NJ 07205 | 2006-10-24 |
| 1376169094 | Community Smiles of Elizabeth Pa | Dentist | 1100 N Broad St, Hillside, NJ 07205 | 2020-06-18 |
| 1679041628 | Pharmacotherapy LLC | Respite Care | 58 Blackburn Rd, Hillside, NJ 07205 | 2018-11-07 |
| 1215440243 | Taheerah Nicole Hardy | Technician/Technologist | 1151 Liberty Ave, Hillside, NJ 07205 | 2017-11-13 |
| 1851810832 | Cherion Jasmine Fullerton-coley | Nurse Practitioner | 1295 State Street, Hillside, NJ 07205 | 2017-09-11 |
| Find all providers in zip 07205 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760021703 | Monica Bembry | Specialist | 552 N Mannheim Rd Ste B, Hillside, IL 60162-1121 | 2019-12-21 |
| 1013570142 | Tonya Lawson | Specialist | 1536a Liberty Ave, Hillside, NJ 07205-1331 | 2019-04-15 |
| 1023461852 | Erskine Reeves | Specialist | 552 N Mannheim Rd, Hillside, IL 60162-1121 | 2016-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433471 | Sara Pineda | Specialist | 806 Livingston Ave, North Brunswick, NJ 08902-2354 | 2019-08-19 |
| 1225509136 | Carmesha L Atwater | Specialist | 269 Varick St, Jersey City, NJ 07302-4032 | 2018-12-17 |
| 1871064477 | Deja L Farley | Specialist | 370 W 4th Ave, Roselle, NJ 07203-1138 | 2018-12-09 |
| 1912495060 | Angela Phipps | Specialist | 209 Clinton Pl, Hackensack, NJ 07601-3673 | 2018-04-24 |
| 1437653623 | Miya M Fish | Specialist | 84 E Cherry St, Rahway, NJ 07065-4012 | 2018-03-21 |
| 1538676754 | Londyn Dior Salon LLC | Specialist | 1 Berlin Rd Bldg 4, Clementon, NJ 08021-4548 | 2018-01-09 |
| 1093227860 | Tangible Beauty Enterprises LLC | Specialist | 200 Haddonfield Berlin Rd Ste 3, Voorhees, NJ 08043-1400 | 2017-11-01 |
| 1063952729 | Ronnie C Yuen Jr. | Specialist | 409 N White Horse Pike, Unit- D, Somerdale, NJ 08083-1547 | 2017-02-28 |
| 1639611098 | Stacy Hammond | Specialist | 3 Buchanan St, Cranford, NJ 07016-3426 | 2016-11-15 |
| 1972976173 | Taneice Chavers | Specialist | 457 Pleasant Valley Way, West Orange, NJ 07052 | 2015-11-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.