Healthcare Provider Details

I. General information

NPI: 1508678566
Provider Name (Legal Business Name): KAITLIN KUWITZKY PA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 08/01/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CORONADO WAY
MALTA NY
12020-6342
US

IV. Provider business mailing address

PO BOX 3203
SCHENECTADY NY
12303-0203
US

V. Phone/Fax

Practice location:
  • Phone: 518-791-2786
  • Fax: 877-583-1284
Mailing address:
  • Phone: 518-346-3100
  • Fax: 877-583-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAITLIN KUWITZKY
Title or Position: PHYSICIAN ASSISTANT
Credential: PA
Phone: 518-346-3100