Healthcare Provider Details

I. General information

NPI: 1871129346
Provider Name (Legal Business Name): MRS. EMILIE VALCIN BIEN-AIME
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 NEW SCOTLAND AVE
ALBANY NY
12208-3409
US

IV. Provider business mailing address

77 E MAIN ST
JOHNSTOWN NY
12095-2628
US

V. Phone/Fax

Practice location:
  • Phone: 518-549-6634
  • Fax:
Mailing address:
  • Phone: 518-210-5112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number41902
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: