Healthcare Provider Details

I. General information

NPI: 1275672743
Provider Name (Legal Business Name): DEBORAH ANNE WRIGHT RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38A OLD SPARROWBUSH ROAD
LATHAM NY
12110
US

IV. Provider business mailing address

62 HACKETT BLVD
ALBANY NY
12209-1756
US

V. Phone/Fax

Practice location:
  • Phone: 518-690-0700
  • Fax: 518-724-5757
Mailing address:
  • Phone: 518-465-3318
  • Fax: 518-449-1378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number007849-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: