National Provider Identifier
Kelly Jean Halvonik, RPAC
Kelly Jean Halvonik, RPAC is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Brockport, NY and a listed phone number of (585) 395-0124.
Profile Overview
- NPI
- 1093784704
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- March 15, 2006
- Last Updated
- July 08, 2007
Practice Location
- Interlakes Oncology & Hematology PC
- 156 West Ave.
- Brockport, NY 14420
Phone: (585) 395-0124
Mailing Address
- Interlakes Oncology & Hematology PC
- 211 White Spruce Blvd.
- Rochester,, NY 14623
Specialties
- Medical Physician Assistant (363AM0700X)
Full Record
- NPI
- 1093784704
- Entity Type
- Individual
- Last Name
- Halvonik
- First Name
- Kelly
- Middle Name
- Jean
- Credential
- RPAC
- Provider Other Last Name
- Fardink
- Provider Other First Name
- Kelly
- Provider Other Middle Name
- Jean
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- Interlakes Oncology & Hematology PC
- Mailing Address Line 2
- 211 White Spruce Blvd.
- Mailing City
- Rochester,
- Mailing State
- NY
- Mailing ZIP Code
- 14623
- Mailing Country
- US
- Mailing Phone
- (585) 475-8728
- Mailing Fax
- (585) 475-9411
- Practice Street Address
- Interlakes Oncology & Hematology PC
- Practice Address Line 2
- 156 West Ave.
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420
- Practice Country
- US
- Practice Phone
- (585) 395-0124
- Practice Fax
- (585) 395-0127
- Enumeration Date
- March 15, 2006
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X)