Provider Demographics
NPI:1497590194
Name:COX, MADISON MICHELLE
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MICHELLE
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 NY SH 37-B
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662
Mailing Address - Country:US
Mailing Address - Phone:315-705-1550
Mailing Address - Fax:
Practice Address - Street 1:16 PHILIPS ST., MASSENA NY 13662
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13672
Practice Address - Country:US
Practice Address - Phone:315-764-8076
Practice Address - Fax:315-764-8076
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program