Marjorie E Ketzak (NPI# 1780684159, PAC ID# 1355404062) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1780684159 |
| PAC ID by PECOS | 1355404062 |
| Professional Enrollment ID | I20090107000085 |
| Full Name | Marjorie E Ketzak |
| Organization Legal Name | MARY IMOGENE BASSETT HOSPITAL |
| Address |
130 N St Bassett Healthcare Walton Walton NY 13856-1218 |
| Phone Number | 60786565411 |
| Gender | F |
| Medical School | UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES |
| Graduation Year | 1999 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 3779488325 |
| Number of Group Practice Members | 567 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330408 | TRI-TOWN REGIONAL HEALTHCARE |
| 330394 | UNITED HEALTH SERVICES HOSPITALS, INC |
| 330136 | MARY IMOGENE BASSETT HOSPITAL |
| 330011 | OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC |
| 330033 | CHENANGO MEMORIAL HOSPITAL, INC |
| Address | Phone | Organization |
|---|---|---|
| 41 Grandview Dr, Cobleskill, NY 12043-1320 | 5182543456 | MARY IMOGENE BASSETT HOSPITAL |
| 130 N St, Bassett Healthcare Walton, Walton, NY 13856-1218 | 60786565411 | MARY IMOGENE BASSETT HOSPITAL |
| 130 N St, Walton, NY 13856-1218 | 60786565411 | MARY IMOGENE BASSETT HOSPITAL |
| Organization Legal Name | MARY IMOGENE BASSETT HOSPITAL |
| Physicians | 631 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shannon Gail Stark | Nurse Practitioner | Mary Imogene Bassett Hospital | 1 Atwell Rd, Cooperstown, NY 13326-1301 |
| Nomi-kaie Bennett | Psychologist, Clinical | Mary Imogene Bassett Hospital | 136 Pkwy Dr, Cobleskill, NY 12043-5150 |
| Sarah Hardy | Nurse Practitioner | Mary Imogene Bassett Hospital | 8 Park Pl, St Johnsville, NY 13452-1332 |
| Kristen A Herbst | Orthopedic Surgery | Mary Imogene Bassett Hospital | 1 Associate Dr, Oneonta, NY 13820-2266 |
| Taylen C Peaden | Family Practice | Mary Imogene Bassett Hospital | 170 Burwell St, Little Falls, NY 13365-1716 |
| Laura A Everett | Nurse Practitioner | Mary Imogene Bassett Hospital | 55 Calvary Dr, Norwich, NY 13815-1032 |
| Sarah M | Nurse Practitioner | Mary Imogene Bassett Hospital | 140 Burwell St, Little Falls, NY 13365-1725 |
| Patrick William Mannal | Plastic and Reconstructive Surgery | Mary Imogene Bassett Hospital | Greystone Commercial Park, 4580 State Route 28, Milford, NY 13807-1147 |
| Jennifer Oreilly | Family Medicine | Mary Imogene Bassett Hospital | 39 Pearl St W, Sidney, NY 13838-1330 |
| Robert J Garfield | Family Medicine | Mary Imogene Bassett Hospital | 32 -34 Main St, Stamford, NY 12167-1241 |
| Street Address |
130 N ST BASSETT HEALTHCARE WALTON |
| City | WALTON |
| State | NY |
| Zip | 13856-1218 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan M Fiore | Family Medicine | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Jesse M Welch | Physician Assistant | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| James Boyle | Orthopedic Surgery | Cape Cod Orthopedics and Sports Medicine PC | 130 N St, Hyannis, MA 02601 |
| Jeffrey M Terwilliger | Physician Assistant | Cape Cod Orthopedics and Sports Medicine PC | 130 N St, Hyannis, MA 02601 |
| Daline Derival | Nurse Practitioner | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Trenton Lee Hiles | Physician Assistant | Cape Cod Orthopedics and Sports Medicine PC | 130 N St, Hyannis, MA 02601 |
| O S Raffo | Anesthesiology | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Dean R Sherman | Physical Therapy | Cape Cod Orthopedics and Sports Medicine PC | 130 N St, Hyannis, MA 02601 |
| Devin Lynde Bean | Physician Assistant | Cape Cod Orthopedics and Sports Medicine PC | 130 N St, Hyannis, MA 02601 |
| Jennifer Rae | Physical Therapy | Cape Cod Orthopedics and Sports Medicine PC | 130 N St, Hyannis, MA 02601 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicole Gerace | Clinical Social Worker | 56 Shepard St, Suite 1, Walton, NY 13856-1109 | |
| Christa M Wightman | Physician Assistant | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Sean E Secord | Physician Assistant | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Alysson M Oberwanowicz | Physician Assistant | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| David Keith Barron | Physician Assistant | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Christine Altman | Nurse Practitioner | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Julie B Vernold | Nurse Practitioner | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| John C T Dorr | Nurse Practitioner | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Peter L Sosnow | Emergency Medicine | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Emma Wallace | Physician Assistant | Mary Imogene Bassett Hospital | 130 N St, Walton, NY 13856-1218 |
| Find all physicians in zip 13856 | |||
| City | WALTON |
| Zip Code | 13856 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | WALTON + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Marjorie E Ketzak.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.