Alice MC Cormick DO PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS004730L Issued in PA

Legal business name

ALICE MC CORMICK DO PC

Practice address

1565 Route 507
Greentown, PA 18426-4503

Phone

(570) 676-4276

Fax

(570) 969-9697

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane Arnoni

Title

Administrator

Phone

(570) 969-0663

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942329248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 W OLIVE ST",
            "address_2": "SUITE 201",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082572",
            "telephone_number": "570-969-0663",
            "fax_number": "570-969-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 ROUTE 507",
            "city": "GREENTOWN",
            "state": "PA",
            "postal_code": "184264503",
            "telephone_number": "570-676-4276",
            "fax_number": "570-969-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE MC CORMICK DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARNONI",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-969-0663"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS004730L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010358980008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Abbott, PHARM.D, RPH
• Kelly Anne Adams, BCBA
• Alice McCormick, D.O., P.C.
• Alexa Croley, DPT
• Tamara Cykosky, BCBA
• Edward C Desmet Jr., MSPT
• Devereux Foundation

• Internal Medicine Physician in Greentown, PA
• Providers in Greentown, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.