Most Relevant Information
Provider Data
| NPI Number: | 1003341348 |
| Provider Name: | KAMILAH MCCORMACK |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 313680-1 |
Most Important Dates
| Enumeration Date: | 04/24/2017 |
| Last Updated: | 04/24/2017 |
Provider Practice Location
195 COUNTRY CLUB LN
POMONA
NY
109702457
Practice Location Phone/Fax
| Phone: | 9179918980 |
| Fax: |
Provider Mailing Location
195 COUNTRY CLUB LN
POMONA
NY
109702457
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |