| Jackson Kwok, MD | |
|
8687 Carling Road, Ste C, Liverpool, NY 13090 | |
| (315) 473-3700 | |
| (315) 473-3701 |
| Full Name | Jackson Kwok |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 8687 Carling Road, Liverpool, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174101877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 344256 (New York) | Primary |
| 208000000X | Pediatrics | 0101282056 (Virginia) | Secondary |
| Entity Name | Carilion Healthcare Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447206370 PECOS PAC ID: 5890607253 Enrollment ID: O20031106000273 |
| Entity Name | Carilion Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730123472 PECOS PAC ID: 9830096585 Enrollment ID: O20040107000472 |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Kwok, MD 8687 Carling Road, Ste C, Liverpool, NY 13090 Ph: (315) 473-3700 | Jackson Kwok, MD 8687 Carling Road, Ste C, Liverpool, NY 13090 Ph: (315) 473-3700 |
Meghan Dambach, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 |
Brenda R Van Fossen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7375 Oswego Rd, Liverpool, NY 13090 Phone: 315-291-0064 Fax: 315-291-0065 |
Nicole Autumn Mirjafari, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5100 W Taft Rd Ste 1b, Liverpool, NY 13088 Phone: 239-343-9888 Fax: 239-303-0714 |
Mrs. Maritza Alvarado, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 Fax: 315-457-9854 |
Mrs. Angelle M Cresswell, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Garnoch Ct, Liverpool, NY 13090 Phone: 315-457-0872 |
Dr. Mary V Green, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 Fax: 315-457-9854 |
Fozia Bakshi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 Fax: 315-379-4900 |