Healthcare Provider Details

I. General information

NPI: 1205239340
Provider Name (Legal Business Name): VALERIE GANA REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 BOCES DR
SIDNEY CENTER NY
13839-3105
US

IV. Provider business mailing address

270 BOCES DRIVE
SIDNEY CENTER NY
13838
US

V. Phone/Fax

Practice location:
  • Phone: 607-865-2535
  • Fax:
Mailing address:
  • Phone: 607-865-2535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number424111-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: