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General NPI Number Information
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NPI Number | 1972216661
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Entity Type | Individual
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Provider Name | TERENCE MCCUMISKEY
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Gender | Male
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 13 SCHOOL ST
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City | SHERBURNE
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State | NY
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Zip | 13460-9505
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Country | US
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Telephone | 607-674-8457
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Fax |
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Provider Business Mailing Address
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Address Line | 58 S CHENANGO ST
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City | GREENE
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State | NY
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Zip | 13778-1231
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Country | US
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Telephone | 607-226-2343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 094115
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License Number State | NY
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