Healthcare Provider Details

I. General information

NPI: 1033144613
Provider Name (Legal Business Name): ANNMARIE CERIELLO GAETANI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 WASHINGTON AVE STE 201
ALBANY NY
12206-1098
US

IV. Provider business mailing address

1365 WASHINGTON AVE STE 201
ALBANY NY
12206-1098
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-4446
  • Fax: 518-489-4448
Mailing address:
  • Phone: 518-489-4446
  • Fax: 518-489-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF330201
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330201
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: