Individual
CARA WICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1205 TROY SCHENECTADY RD STE 101, LATHAM, NY 12110-1074
(518) 348-3176
Mailing address
711 TROY SCHENECTADY RD, SUITE 201, LATHAM, NY 12110-2442
(518) 782-3700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
08647
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02848171
—
NY
Enumeration date
12/11/2006
Last updated
10/24/2019
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