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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 01995615 | 05 |
Street Address |
155 FINNEY BLVD. |
City | MALONE |
State | NY |
Zip Code | 12953-1067 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982835930 | Quynh Ngoc Tran | Optometrist | 155 Finney Blvd., Malone, NY 12953-1067 | 2009-08-06 |
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 |
Find all providers in zip 12953 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
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 |
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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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.