DR. MARJORIE KETZAK (NPI# 1780684159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780684159 |
| Entity Type | Individual |
| Full Name | DR. MARJORIE KETZAK |
| Credential | DO |
| Practice Address |
29 N Chenango St Suite A Greene NY 13778-1154 |
| Practice Telephone | 6078754334 |
| Practice Fax Number | 8886039093 |
| Mailing Telephone | 6078754334 |
| Mailing Fax Number | 8886039093 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2016-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2200SG | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02154465 | 05 |
| Street Address |
29 N CHENANGO ST SUITE A |
| City | GREENE |
| State | NY |
| Zip Code | 13778-1154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225685159 | Mary Imogene Bassett Hospital | Clinic/Center | 29 N Chenango St, Greene, NY 13778-1154 | 2019-08-26 |
| 1528216835 | Greene Family Medicine, Pllc | Clinic/Center | 29 N Chenango St, Greene, NY 13778-1139 | 2008-08-29 |
| 1902938012 | Lange and Viglucci Optometrists | Optometrist | 29 N Chenango St, Greene, NY 13778-1139 | 2007-03-12 |
| 1346371986 | Joseph Earl Nelson | Dentist | 29 N Chenango St, Greene, NY 13778-1139 | 2007-03-07 |
| 1043306350 | Michael J Lange | Optometrist | 29 N Chenango St, Greene, NY 13778-1139 | 2006-10-05 |
| 1124114442 | Chris J Viglucci | Optometrist | 29 N Chenango St, Greene, NY 13778-1139 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841547361 | Lindsey Mae Weeks | Registered Nurse | 29 N Chenango St Ste A, Greene, NY 13778 | 2012-08-15 |
| 1881881597 | Matthew John Franco | Massage Therapist | 80 Genesee St, Greene, NY 13778 | 2007-09-26 |
| 1841349289 | Greene Central School District | Local Education Agency (LEA) | 40 S. Canal Street, Greene, NY 13778 | 2007-01-08 |
| 1528310745 | Dana Staley | Physical Therapist | 6 Locust St, Greene, NY 13778-1018 | 2012-10-11 |
| 1750644936 | Kay A Clark | Specialist | 114 Cutler Rd, Greene, NY 13778-1029 | 2012-06-21 |
| 1134379050 | Melissa Marie Collins | Licensed Practical Nurse | 50 Birdsall St, Greene, NY 13778-1049 | 2008-09-28 |
| 1043241599 | Greene Emergency Squad Inc | Ambulance | 30 Birdsall St, Greene, NY 13778-1050 | 2006-07-05 |
| 1356341622 | Martin Masarech | Family Medicine | 15 Birdsall St, Greene, NY 13778-1057 | 2005-07-28 |
| 1063896728 | Sarah Lane | Nurse Practitioner | 15 Birdsall St, Greene, NY 13778-1057 | 2015-07-13 |
| 1578990461 | Genevieve Romano-helm | Nurse Practitioner | 15 Birdsall St, Greene, NY 13778-1057 | 2013-10-09 |
| Find all providers in zip 13778 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063720076 | William Seth Hallenbeck IIi | Family Medicine | 248 Race Rd, Greene, NY 13778-4157 | 2010-09-24 |
| 1356341622 | Martin Masarech | Family Medicine | 15 Birdsall St, Greene, NY 13778-1057 | 2005-07-28 |
| 1669470969 | Pamela Joyce Wansker | Family Medicine | 344 Route 202, Box 539, Greene, ME 04236-4208 | 2005-07-11 |
| 1497763841 | North Iowa Mercy Clinics | Family Medicine | 104 E Traer St, Greene, IA 50636-0000 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
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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.