Individual
MS. MARY K MICHALAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
147 LAKE ST, NEWBURGH, NY 12550-5242
(845) 563-8000
Mailing address
2570 ROUTE 9W, SUITE 10, CORNWALL, NY 12518-1323
(845) 563-8000
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
001913
NY
363AM0700X
Medical Physician Assistant
Primary
013621
NY
Other
Enumeration date
02/06/2007
Last updated
03/21/2019
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