MS. MARY K KOWALCHUK


Address: 155 Finney Blvd., Malone, NY 12953-1067
Phone: 5184830109

MS. MARY K KOWALCHUK (NPI# 1427049139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427049139
Entity Type Individual
Full Name MS. MARY K KOWALCHUK
Credential PA-C
Practice Address 155 Finney Blvd.
Malone
NY 12953-1067
Mailing Address 4 Commerce Lane
Canton
NY 13617-3739
Practice Telephone 5184830109
Practice Fax Number 5184830201
Mailing Telephone 3153868191
Mailing Fax Number 3153861410
Enumeration Date 2005-11-02
Last Update Date 2012-03-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
009127 NY Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY 01995615 05

Office Location

Street Address 155 FINNEY BLVD.
City MALONE
State NY
Zip Code 12953-1067

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982835930 Quynh Ngoc Tran Optometrist 155 Finney Blvd., Malone, NY 12953-1067 2009-08-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386264356 Ruth Ann Williamson Nurse Practitioner 31 Sixth St., Malone, NY 12953 2020-04-20
1780203760 Heather Lynn Lauzon Peer Specialist 15 Fouth St, Malone, NY 12953 2020-04-10
1245717115 Darlean James Family Medicine 183 Park St Ste 5678, Malone, NY 12953 2018-07-24
1164929212 Cheryl Ann Grant Registered Nurse 15 Fourth Street, Malone, NY 12953 2018-04-06
1811408826 Nancy Denis Registered Nurse 133 Park Street, Alice Hyde Medical Center, Malone, NY 12953 2017-10-17
1003325424 Tara Lynn Ellis Registered Nurse 23 Husky Lane, Malone, NY 12953 2017-09-28
1578092185 Shanna Lee Cayea Peer Specialist 31 6th Street, Malone, NY 12953 2017-06-07
1184007809 Alice Hyde Medical Center Home Health 45 Sixth St, Malone, NY 12953 2015-06-30
1427303353 Melissa J Benardot Nurse Practitioner 380 Cty Rt 57, Community Health Center, Malone, NY 12953 2012-07-17
1013272202 Shafiu Oladele Ololade Internal Medicine 10 Third Street, Malone, NY 12953 2012-07-12
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639465941 Erika A Thompson Physician Assistant 183 Park St, Suite 5 & 6, Malone, NY 12953-1238 2011-06-24
1194019935 Bang Cao To Physician Assistant 133 Park St, Malone, NY 12953-1243 2011-06-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1487252581 North Shore Medical Group Pllc Physician Assistant 311 Skyview Ter, Syracuse, NY 13219-2835 2020-10-12
1477169654 Kristen Ariel O'connell Physician Assistant 85 John St Apt 7a, New York, NY 10038-2844 2020-09-22
1699381616 David Nmn Kao Physician Assistant 737 Pleasant Avenue, Westbury, NY 11590-6407 2020-09-16
1043824816 Elizabeth Keane Physician Assistant 25 Hollis Dr, Sound Beach, NY 11789-1629 2020-08-31
1497364111 Tianna Stephens Physician Assistant 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 2020-07-28
1124636188 Shannon Maureen O'connell Physician Assistant 270-05 270th Ave, New Hyde Park, NY 11040 2020-07-16
1841818895 Yanick Dugue Physician Assistant 4 Lincoln Ave, New Hyde Park, NY 11040-3125 2020-07-07
1194340505 Kayleigh Marie Tourt Physician Assistant 222 Alexander St Fl 4, Rochester, NY 14607-4039 2020-06-11
1023638509 Kristina Rajic Physician Assistant 7237 66th Dr, Flushing, NY 11379-2111 2020-04-24
1114547791 Michele Hein Physician Assistant 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 2020-04-23
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Competitor

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City MALONE
Zip Code 12953

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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