Healthcare Provider Details

I. General information

NPI: 1841626157
Provider Name (Legal Business Name): AMY MARIE ROWE P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 DRESSLER RD NW
CANTON OH
44718-2545
US

IV. Provider business mailing address

4270 QUEEN PHILOMENA BLVD APT #4
SCHENECTADY NY
12304-1885
US

V. Phone/Fax

Practice location:
  • Phone: 800-828-0898
  • Fax:
Mailing address:
  • Phone: 607-226-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number016925-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: