Individual
DAMIANN MACGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 CHEMUNG PL, JERICHO, NY 11753-1502
(516) 470-0985
Mailing address
16 CHEMUNG PL, JERICHO, NY 11753-1502
(516) 470-0985
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012587-1
NY
363A00000X
Physician Assistant
MA051256
PA
Other
Enumeration date
12/21/2006
Last updated
05/07/2012
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