Healthcare Provider Details

I. General information

NPI: 1528997574
Provider Name (Legal Business Name): JAQUALYN IARDELLA NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PINE WEST PLZ STE 205
ALBANY NY
12205-5532
US

IV. Provider business mailing address

2 PINE WEST PLZ STE 205
ALBANY NY
12205-5532
US

V. Phone/Fax

Practice location:
  • Phone: 518-727-4611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAQUALYN SUSAN IARDELLA
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 518-727-7665