Individual
HEIDI M CZAJKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
522 S 4TH ST, SUITE 500, FULTON, NY 13069-2946
(315) 598-4790
(315) 598-4719
Mailing address
239 ONEIDA ST, FULTON, NY 13069-1228
(315) 592-0721
(315) 598-4733
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
013632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02997217
—
NY
Enumeration date
11/03/2009
Last updated
07/27/2011
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