Healthcare Provider Details

I. General information

NPI: 1679091136
Provider Name (Legal Business Name): BROOKE MARIE CISLER FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN MARIE CISLER

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 GUY PARK AVE
AMSTERDAM NY
12010-1064
US

IV. Provider business mailing address

12 PAUL HOLLY DR
ALBANY NY
12211-1706
US

V. Phone/Fax

Practice location:
  • Phone: 518-842-1900
  • Fax:
Mailing address:
  • Phone: 716-462-0083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF341889-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF403391-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: