Healthcare Provider Details

I. General information

NPI: 1154604148
Provider Name (Legal Business Name): PATRICIA J GILROY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 SLINGERLAND ST
ALBANY NY
12202-1223
US

IV. Provider business mailing address

507 WATERVLIET SHAKER RD
LATHAM NY
12110-4622
US

V. Phone/Fax

Practice location:
  • Phone: 518-463-2247
  • Fax: 518-463-9880
Mailing address:
  • Phone: 518-785-7617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number484870-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: