MICHAEL P KETZAK (NPI# 1356794903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356794903 |
| Entity Type | Individual |
| Full Name | MICHAEL P KETZAK |
| Credential | NP |
| Practice Address |
114 Clinton St Binghamton NY 13905-2212 |
| Practice Telephone | 6077970680 |
| Practice Fax Number | 6077974315 |
| Mailing Telephone | 6077970680 |
| Mailing Fax Number | 6077974315 |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
F402042-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
114 CLINTON ST |
| City | BINGHAMTON |
| State | NY |
| Zip Code | 13905-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697251 | Ashley Elizabeth Satterfield | Nurse Practitioner | 114 Clinton St, Binghamton, NY 13905-2212 | 2020-10-16 |
| 1902367592 | Ashley Gray | Psychologist | 114 Clinton St, Binghamton, NY 13905-2212 | 2019-03-27 |
| 1326542838 | Juanita Marie Delgado | Registered Nurse | 114 Clinton St, Binghamton, NY 13905-2212 | 2018-03-20 |
| 1720527401 | Emina Mujic | Social Worker | 114 Clinton St, Binghamton, NY 13905-2212 | 2017-02-15 |
| 1659817708 | Carrie Govas | Social Worker | 114 Clinton St, Binghamton, NY 13905-2212 | 2017-01-13 |
| 1578006524 | Danita Williams | Psychologist | 114 Clinton St, Binghamton, NY 13905-2212 | 2016-11-23 |
| 1770031429 | Sheena Fenescey | Social Worker | 114 Clinton St, Binghamton, NY 13905-2212 | 2016-09-12 |
| 1902278070 | Heather Gordon | Social Worker | 114 Clinton St, Binghamton, NY 13905-2212 | 2015-10-28 |
| 1992177737 | Casey Allen | Social Worker | 114 Clinton St, Binghamton, NY 13905-2212 | 2015-10-20 |
| 1790156743 | Gary Billings | Licensed Practical Nurse | 114 Clinton St, Binghamton, NY 13905-2212 | 2015-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689222820 | Pamela K Wheaton | Counselor | 40 Front Sreet, Suite K, Binghamton, NY 13905 | 2019-08-30 |
| 1417422593 | Justin William Arnold | Massage Therapist | 1235 Front St, Suite 4, Binghamton, NY 13905 | 2018-10-04 |
| 1366886632 | Lalor Family Dental Pllc | Dentist | 1216 Upper Front Street, Binghamton, NY 13905 | 2013-04-17 |
| 1699015172 | Radharani Mohanty | Pediatrics | 1 Ely Park Blvd - M4, Binghamton, NY 13905 | 2013-02-21 |
| 1710260344 | Michelle L. Rease | Registered Nurse | 40 Front St. Suite C, C/o Riverside Anesthesia, Binghamton, NY 13905 | 2011-09-20 |
| 1508173337 | John D Newman | Registered Nurse | 169 Riverside Dr., Our Lady of Lourdes Hospital, Binghamton, NY 13905 | 2010-08-31 |
| 1073758330 | Jennifer Lynn Kolesar | Pharmacist | Cvs Pharmacy 68 Main St., Binghamton, NY 13905 | 2008-12-15 |
| 1245355155 | Tara Jayant Belsare | Psychiatry & Neurology | 38 Riverside Drive, Binghamton, NY 13905 | 2007-03-20 |
| 1659411866 | State of New York | Intermediate Care Facility, Mentally Retarded | Glenwood Rd, Binghamton, NY 13905 | 2007-02-07 |
| 1528133956 | Judith Tanzer | Social Worker | 35 Front Street, Binghamton, NY 13905 | 2006-11-21 |
| Find all providers in zip 13905 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265815211 | Miriam Mikaya | Nurse Practitioner | 10-42 Mitchel Avenue, Binghamton, NY 13903 | 2015-07-08 |
| 1922181254 | Barbara J Fortunato | Nurse Practitioner | 2-8 Hawley St., Berkshire Farm Center for Youth, Binghamton, NY 13901-3114 | 2006-10-23 |
| 1821697251 | Ashley Elizabeth Satterfield | Nurse Practitioner | 114 Clinton St, Binghamton, NY 13905-2212 | 2020-10-16 |
| 1164070793 | Portia Johnson | Nurse Practitioner | 4400 Vestal Pkwy E, Binghamton, NY 13902-4400 | 2019-08-27 |
| 1740836089 | Kathleen N Mignone | Nurse Practitioner | 30 W State St, Binghamton, NY 13901-2357 | 2019-08-13 |
| 1003476888 | Maribeth Evans | Nurse Practitioner | 10-42 Mitchell Ave, Binghamton, NY 13903-1617 | 2019-06-14 |
| 1437719143 | Colleen M Coddington | Nurse Practitioner | 184 Court St, Binghamton, NY 13901-3515 | 2019-06-14 |
| 1871054460 | Maria Askew | Nurse Practitioner | 10-42 Mitchell Ave, Binghamton, NY 13903-1617 | 2019-03-27 |
| 1073071718 | Linda Niles | Nurse Practitioner | 10-42 Mitchell Ave, Binghamton, NY 13903-1617 | 2019-03-12 |
| 1598223174 | Nicole Mikula | Nurse Practitioner | 10-42 Mitchell Ave, Binghamton, NY 13903-1617 | 2019-03-04 |
| Find all providers in BINGHAMTON | ||||
| City | BINGHAMTON |
| Zip Code | 13905 |
Please comment or provide details below to improve the information on MICHAEL P KETZAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.