Healthcare Provider Details

I. General information

NPI: 1659523496
Provider Name (Legal Business Name): ABBY S HORNYAK RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 GENESEE ST
UTICA NY
13501-5930
US

IV. Provider business mailing address

2211 GENESEE STREET
UTICA NY
13501
US

V. Phone/Fax

Practice location:
  • Phone: 315-733-7598
  • Fax: 315-733-7694
Mailing address:
  • Phone: 315-733-7598
  • Fax: 315-733-7694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number012797
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: