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>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1649590365

Individual Registrant:
Gender: F
Sole Proprietor

Location and contact information for practice:
11835 RT 9W  WEST COXSACKIE, NY 12192-3605 US
Tel: 518-731-9000  Fax: --

Contact information for business:
11835 RT 9W  WEST COXSACKIE, NY 12192-3605 US
Tel: 518-731-9000  Fax: --

Registration Information:
NPI: 1649590365
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant

Legacy codes, insurance codes and state license numbers:



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