Healthcare Provider Details

I. General information

NPI: 1982117891
Provider Name (Legal Business Name): BARBARA LYNN VANDYCK REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS BARBARA LYNN BELCHER

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BALLSTON AVE
BALLSTON SPA NY
12020-3606
US

IV. Provider business mailing address

320 MIDDLE GROVE RD
MIDDLE GROVE NY
12850-1105
US

V. Phone/Fax

Practice location:
  • Phone: 518-884-7200
  • Fax:
Mailing address:
  • Phone: 518-569-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number388311
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: