MR. DWAYNE K MCCORMICK SR.


Address: 542 Bloy St, Hillside, NJ 07205-1744
Phone: 9732776354

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1744P3200X Specialist
Specialization: Prosthetics Case Management
32WG07436100 NJ Other Service Providers

Office Location

Street Address 542 BLOY ST
City HILLSIDE
State NJ
Zip Code 07205-1744

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Taxonomy Information

Taxonomy Code 1744P3200X
Grouping Other Service Providers
Classification Specialist
Specialization Prosthetics Case Management

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1760021703 Monica Bembry Specialist 552 N Mannheim Rd Ste B, Hillside, IL 60162-1121 2019-12-21
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1023461852 Erskine Reeves Specialist 552 N Mannheim Rd, Hillside, IL 60162-1121 2016-07-17

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NPI Name Taxonomy Address Enumeration
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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
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1093227860 Tangible Beauty Enterprises LLC Specialist 200 Haddonfield Berlin Rd Ste 3, Voorhees, NJ 08043-1400 2017-11-01
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Competitor

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City HILLSIDE
Zip Code 07205

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Dataset Information

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.

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