Individual
CASEY OWEN DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
522 S 4TH ST STE 1700, FULTON, NY 13069-2918
(315) 592-3930
Mailing address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
357028
NY
Other
Enumeration date
09/13/2025
Last updated
09/13/2025
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