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General NPI Number Information
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NPI Number | 1265828180
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Entity Type | Organization
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Legal Business Name | MCCORMICK SHOULDER AND SPORTS SURGICAL SPECIALISTS PLLC
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 29 EAST 29 STREET 1ST FLOOR BLDG B SUITE 401
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City | BAYONNE
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State | NJ
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Zip | 07002
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Country | US
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Telephone | 844-954-7627
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Fax |
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Provider Business Mailing Address
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Address Line | 2536 SE 9TH ST
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City | POMPANO BEACH
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State | FL
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Zip | 33062-6709
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Country | US
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Telephone | 617-803-5832
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Fax |
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | DR. FRANK MCCORMICK
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Credential | MD
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Telephone | 617-803-5832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME116967
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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