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General NPI Number Information
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NPI Number | 1053182139
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Entity Type | Organization
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Legal Business Name | THE ON CALL FAMILY HEALTH NURSE PRACTITIONER
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 26 MALL WAY STE 20
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City | WEST SAND LAKE
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State | NY
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Zip | 12196-2064
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Country | US
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Telephone | 518-249-6889
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Fax |
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Provider Business Mailing Address
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Address Line | 221 SPRINGER RD
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City | WEST SAND LAKE
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State | NY
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Zip | 12196-2035
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Country | US
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Telephone | 518-249-6889
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Fax |
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Authorized Official
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Title or Position | FAMILY HEALTH NURSE PRACTITIONER
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Name | SARAH OWENS
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Credential | NP
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Telephone | 518-738-7384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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