Provider Demographics
NPI:1043981814
Name:ON CARE FAMILY HEALTH NP, PLLC
Entity Type:Organization
Organization Name:ON CARE FAMILY HEALTH NP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARTAK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:315-256-1249
Mailing Address - Street 1:4591 STONELEDGE LN
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-2375
Mailing Address - Country:US
Mailing Address - Phone:315-256-1249
Mailing Address - Fax:315-949-2046
Practice Address - Street 1:4591 STONELEDGE LN
Practice Address - Street 2:
Practice Address - City:MANLIUS
Practice Address - State:NY
Practice Address - Zip Code:13104-2375
Practice Address - Country:US
Practice Address - Phone:315-256-1249
Practice Address - Fax:315-949-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty