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General NPI Number Information
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NPI Number | 1164169694
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Entity Type | Organization
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Legal Business Name | MARY E VANALSTYNE NURSE PRACTITIONER IN FAMILY HEALTH PC
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 6 CHELSEA PL STE 103
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3236
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Country | US
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Telephone | 518-763-7701
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Fax |
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Provider Business Mailing Address
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Address Line | 6 CHELSEA PL STE 103
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3236
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Country | US
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Telephone | 518-763-7701
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MARY VANALSTYNE
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Credential | NP
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Telephone | 518-763-7701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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