Individual
MR. CONNOR WASILNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
30 HARRISON ST STE 250, JOHNSON CITY, NY 13790-2176
(607) 763-6580
(607) 763-6782
Mailing address
33 LEWIS RD, FL 2, BINGHAMTON, NY 13905-1055
(607) 770-0025
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2021
Last updated
09/21/2022
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