Individual
JONATHAN LOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 PARK STREET, MALONE, NY 12953
(518) 483-1120
(518) 483-9419
Mailing address
130 PARK STREET, MALONE, NY 12953
(518) 483-1120
(518) 483-9419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
134140
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00632655
—
NY
01
—
A81036
FR CO NURSING HOME
NY
Enumeration date
08/31/2006
Last updated
04/01/2008
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