Healthcare Provider Details

I. General information

NPI: 1437558301
Provider Name (Legal Business Name): REBECCA HEGEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2014
Last Update Date: 08/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S MANNING BLVD
ALBANY NY
12208-1771
US

IV. Provider business mailing address

6 BACKSTREATCH CT
SARATOGA SPRINGS NY
12866-7343
US

V. Phone/Fax

Practice location:
  • Phone: 518-525-2323
  • Fax:
Mailing address:
  • Phone: 518-522-7224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8654099
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: