Provider Demographics
NPI:1073963500
Name:NOWAK, CORINNE (PA-C)
Entity Type:Individual
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First Name:CORINNE
Middle Name:
Last Name:NOWAK
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:245 HARTFORD AVE STE 1
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-3007
Practice Address - Country:US
Practice Address - Phone:774-295-4355
Practice Address - Fax:774-295-4880
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2023-11-17
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Provider Licenses
StateLicense IDTaxonomies
MA5738363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant