Provider Demographics
NPI:1003568841
Name:MCCURDY, THOMAS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MCCURDY
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 44TH DR APT 205
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-3024
Mailing Address - Country:US
Mailing Address - Phone:917-297-6949
Mailing Address - Fax:
Practice Address - Street 1:2721 44TH DR APT 205
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3024
Practice Address - Country:US
Practice Address - Phone:917-297-6949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01244100363L00000X
CT12.009763363L00000X
FL11013353363L00000X
NY310415363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner