Cory Lynn Nordyke, LMT, MMP
Individual provider Active NPI Specialist · Tamiment, PA
NPI 1609323146 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1609323146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MSG010794 (PA)
- Practice address
- 503 Carrock Way
Tamiment, PA 18371 - Phone
- (570) 431-3344
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSG010794 | PA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MSG010794 | PA | Yes |
Addresses
Primary practice location
503 Carrock Way
Tamiment, PA 18371
Mailing address
503 Carrock Way
Tamiment, PA 18371
Other providers in Tamiment, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.