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Individual

JEAN G. HOLLOWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
23 HACKETT BLVD, MC 208, ALBANY, NY 12208-3436
(518) 262-3341
(518) 262-6660
Mailing address
711 TROY SCHENECTADY RD, SUITE 201, LATHAM, NY 12110-2442
(518) 213-0478
(518) 782-3799

Taxonomy

Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
175342-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010066379
VA
05
01095692
NY
01
138022
ANTHEM BCBS
VA
01
2125582
ALLIANCE/MDIPA
VA
01
311610834
NC HEALTH CHOICE
VA
01
3116108340006E
CIGNA
VA
01
4239662
AETNA
VA
01
76601
OPTIMA/SENTARA HEALTH
VA
01
790668J
NORTH CAROLINA MEDICAID
VA
Enumeration date
07/31/2006
Last updated
04/12/2010
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