Healthcare Provider Details

I. General information

NPI: 1245679596
Provider Name (Legal Business Name): LATCHMI CIPRIANA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FRANKLIN ST STE 204
SCHENECTADY NY
12305-2100
US

IV. Provider business mailing address

79 GLENRIDGE RD
GLENVILLE NY
12302-4523
US

V. Phone/Fax

Practice location:
  • Phone: 518-372-7031
  • Fax: 518-372-7064
Mailing address:
  • Phone: 518-952-8408
  • Fax: 518-399-6860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number647002
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: