Provider Demographics
NPI:1760264972
Name:MROWKA, AMY ROSE (NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ROSE
Last Name:MROWKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROSE
Other - Last Name:ALCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1706 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9706
Mailing Address - Country:US
Mailing Address - Phone:315-278-2776
Mailing Address - Fax:
Practice Address - Street 1:736 IRVING AVE # 9100
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1602
Practice Address - Country:US
Practice Address - Phone:315-470-7379
Practice Address - Fax:315-470-2923
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF383576-01363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal