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Individual

DR. MARJORIE KETZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
4207 STATE HIGHWAY 220, OXFORD, NY 13830-4305
(607) 843-3140
(607) 843-3162
Mailing address
4207 STATE HIGHWAY 220, OXFORD, NY 13830-4305
(607) 843-3140
(607) 843-3162

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2200SG
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02154465
NY
Enumeration date
07/28/2005
Last updated
11/27/2020
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