person
Mary Bucknam, PA
Medical Physician Assistant in Ithaca, New York
NPI 1104906726

Mary Bucknam is a Medical Physician Assistant based in Ithaca, NY and is specialized in Medical. Mary Bucknam practices in Ithaca, NY and has the professional credentials of PA. The NPI Number for Mary Bucknam is 1104906726 and holds a License No. 0032601 (New York).

The current practice location address for Mary Bucknam is 1301 Trumansburg Rd, Ithaca, NY and can be reached out via phone at 607-272-6880 and via fax at 607-272-1436. You can also correspond with Mary Bucknam through the mailing address at 1301 TRUMANSBURG RD, ITHACA, NY - 14850-1397 (mailing address contact number: 607-272-6880).

Location: 1301 Trumansburg Rd, Ithaca, NY, 14850-1397
person
Provider Profile Details
NPI Number
1104906726
Provider Name
Mary Bucknam
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
1301 Trumansburg Rd, Ithaca, NY, 14850-1397
Phone Number
607-272-6880
Fax Number
607-272-1436
Provider Enumeration Date
10/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02060933 05 NY
institution
Provider Business Practice Location Address Details
Address
1301 Trumansburg Rd
City
State
Zip
14850-1397
Phone Number
607-272-6880
Fax Number
607-272-1436
person
Provider Business Mailing Address Details
Address
1301 Trumansburg Rd
City
State
Zip
14850-1397
Phone Number
607-272-6880
Fax Number
607-272-1436
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
0032601 (New York)
Definition
Definition to come...
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