Provider Demographics
NPI:1376358903
Name:MCCOY- BURNETT, SEAN D
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:D
Last Name:MCCOY- BURNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONTGOMERY PL
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5616
Mailing Address - Country:US
Mailing Address - Phone:609-575-6438
Mailing Address - Fax:
Practice Address - Street 1:14 MONTGOMERY PL
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5616
Practice Address - Country:US
Practice Address - Phone:609-575-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula