Provider Demographics
NPI:1487745857
Name:JAWORSKI, MICHAEL E (RPA-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:JAWORSKI
Suffix:
Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:1561 RTE 9W
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5410
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-202-6005
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY007871363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY348992OtherMVP HEALTH PLAN
NY000498383001OtherBS NORTHEASTERN NY
NY348992OtherMVP HEALTH PLAN