Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin Lee Larose, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1033701719

Kevin Lee Larose, PHYSICIANASSISTANT is a Physician Assistant in Fort Drum, New York. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone: (315) 772-2778
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1178786

Record details

NPI number1033701719
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedFebruary 4, 2021
Last updated in NPPESMay 2, 2024
Certification dateMay 2, 2024

Other providers in Fort Drum