Provider Demographics
NPI:1659422079
Name:MCCANN, HENRY NORMAN III (DAOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:NORMAN
Last Name:MCCANN
Suffix:III
Gender:M
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MAIN ST
Mailing Address - Street 2:SUITE 12-3
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1936
Mailing Address - Country:US
Mailing Address - Phone:974-660-0110
Mailing Address - Fax:
Practice Address - Street 1:12 MAIN ST
Practice Address - Street 2:SUITE 12-3
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1936
Practice Address - Country:US
Practice Address - Phone:974-660-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMZ00180171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist