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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

KELLY JEAN HALVONIK RPAC
NPI 1093784704
Physician Assistant - Medical in Brockport, NY

Active since March 15, 2006
INTERLAKES ONCOLOGY & HEMATOLOGY PC, 156 WEST AVE., BROCKPORT, NY 14420(585) 395-0124(585) 395-0127 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Jean Halvonik Rpac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY JEAN HALVONIK RPAC (NPI 1093784704) is an individual medical provider in Brockport, New York, licensed in New York (004379-1) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1093784704
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKELLY JEAN HALVONIKCredential: RPAC
Location AddressINTERLAKES ONCOLOGY & HEMATOLOGY PC, 156 WEST AVE.Brockport, NY 14420
Mailing AddressInterlakes Oncology & Hematology Pc, 211 White Spruce Blvd.Rochester,, NY 14623 · (585) 475-8728 · Fax (585) 475-9411
Phone(585) 395-0124
Fax(585) 395-0127
Sole ProprietorNo
Enumeration DateMarch 15, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1093784704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 004379-1
INTERLAKES ONCOLOGY & HEMATOLOGY PC, Brockport, NY 14420
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Other Names 1

Former Name (1)Kelly Jean Fardink

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Halvonik's NPI number?

The NPI number for Kelly Halvonik is 1093784704. It was assigned to this individual provider in the NPPES registry on March 15, 2006. The provider is also known as Kelly Jean Fardink.

Where is Kelly Halvonik located?

Kelly Halvonik practices at Interlakes Oncology & Hematology PC 156 West Ave., Brockport, NY 14420. The listed phone number is (585) 395-0124.

What is Kelly Halvonik's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Kelly Halvonik was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.