Healthcare Provider Details

I. General information

NPI: 1225662414
Provider Name (Legal Business Name): GENEVIEVE MAILLOUX NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 07/27/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 ALTAMONT AVE
SCHENECTADY NY
12303-1039
US

IV. Provider business mailing address

7 SOUTHWOODS BLVD STE 17
ALBANY NY
12211-2564
US

V. Phone/Fax

Practice location:
  • Phone: 518-346-6121
  • Fax:
Mailing address:
  • Phone: 518-292-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number700968
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF355867
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: