Provider Demographics
NPI:1710169586
Name:MCCORMICK, NORA V (ATC)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:V
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:ATC
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Mailing Address - Street 1:132 MONMOUTH PARK HWY
Mailing Address - Street 2:SHORE REGIONAL HIGH SCHOOL
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1305
Mailing Address - Country:US
Mailing Address - Phone:732-222-9300
Mailing Address - Fax:732-222-1212
Practice Address - Street 1:132 MONMOUTH PARK HWY
Practice Address - Street 2:SHORE REGIONAL HIGH SCHOOL
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1305
Practice Address - Country:US
Practice Address - Phone:732-222-9300
Practice Address - Fax:732-222-1212
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MT001097002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer