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NPI Code Detail

MEDICARE: CHRISTINE ELIZABETH MCGOVERN RPA-C

MEDICARE: CHRISTINE ELIZABETH MCGOVERN RPA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant0004254NY

General Provider Information

NPI Number : 1124185590
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ELIZABETH MCGOVERN RPA-C
Provider Business Mailing Address
First Line : 1400 WASHINGTON AVE
Second Line : UNIVERSITY HEALTH CENTER
City : ALBANY
State : NY
Zip : 12222-0100
Country : US
Telephone Number : 518-442-5454
Fax Number :
Provider Business Practice Location Address
First Line : 1400 WASHINGTON AVE
Second Line : UNIVERSITY HEALTH CENTER
City : ALBANY
State : NY
Zip : 12222-0100
Country : US
Telephone Number : 518-442-5454
Fax Number : 518-442-5444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 08/03/2007

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Directions to “ CHRISTINE ELIZABETH MCGOVERN RPA-C” Practice Location

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