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General NPI Number Information
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NPI Number | 1245623511
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Entity Type | Organization
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Legal Business Name | AMY STORY
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 5 VALLEY VIEW BLVD APT 624
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City | RENSSELAER
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State | NY
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Zip | 12144-9358
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Country | US
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Telephone | 518-788-2410
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Fax |
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Provider Business Mailing Address
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Address Line | 5 VALLEY VIEW BLVD APT 624
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City | RENSSELAER
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State | NY
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Zip | 12144-9358
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | AMY STORY
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Credential |
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Telephone | 518-788-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 307995-1
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License Number State | NY
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