Individual
HEATHER M MALCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
70 NORTH WEST ST, HOMER, NY 13077
(315) 225-0976
Mailing address
70 N. WEST ST, HOMER, NY 13077
(315) 225-0976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
621264
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
311918
NY
Other
Enumeration date
04/23/2024
Last updated
08/05/2024
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