Provider Demographics
NPI:1366515728
Name:KOLYNICH, JAMES FRANK (PA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FRANK
Last Name:KOLYNICH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 DRAHT HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-9404
Mailing Address - Country:US
Mailing Address - Phone:607-732-0034
Mailing Address - Fax:
Practice Address - Street 1:100 WASHINGTON STREET
Practice Address - Street 2:ELMIRA PSYCHIATRIC CENTER
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901
Practice Address - Country:US
Practice Address - Phone:607-737-4769
Practice Address - Fax:607-737-4813
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001143-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical