Provider Demographics
NPI:1366923732
Name:FLEMMING, MCKENZIE LEIGH (PA-C)
Entity type:Individual
Prefix:MISS
First Name:MCKENZIE
Middle Name:LEIGH
Last Name:FLEMMING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:
Other - Last Name:JAAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:
Practice Address - Street 1:2388 ROUTE 9
Practice Address - Street 2:
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-3433
Practice Address - Country:US
Practice Address - Phone:518-782-3899
Practice Address - Fax:518-782-3884
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant