Provider Demographics
NPI:1831925122
Name:MCCOY, HIJAZI (MSN, APN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HIJAZI
Middle Name:
Last Name:MCCOY
Suffix:
Gender:
Credentials:MSN, APN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 TANYARD RD STE C100
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-4222
Mailing Address - Country:US
Mailing Address - Phone:855-932-7476
Mailing Address - Fax:856-566-6320
Practice Address - Street 1:10000 LINCOLN DR E STE 201
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3105
Practice Address - Country:US
Practice Address - Phone:201-500-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15098800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health