Healthcare Provider Details

I. General information

NPI: 1093631475
Provider Name (Legal Business Name): MCKENNA MERCEDES RAAYMAKERS AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 EVERETT RD
ALBANY NY
12205-1407
US

IV. Provider business mailing address

21 ERIE BLVD APT 314
MENANDS NY
12204-2547
US

V. Phone/Fax

Practice location:
  • Phone: 518-701-2085
  • Fax:
Mailing address:
  • Phone: 518-741-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: