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Individual
MICHAEL P KETZAK
Active
Individual
MICHAEL P KETZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402042-1
NY
Other
Enumeration date
07/19/2016
Last updated
06/22/2022
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