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General NPI Number Information
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NPI Number | 1245998145
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Entity Type | Individual
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Provider Name | TERRA LEE STOWELL RRA
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Gender | Female
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 427 GUY PARK AVE
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City | AMSTERDAM
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State | NY
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Zip | 12010-1064
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Country | US
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Telephone | 518-841-7217
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Fax |
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Provider Business Mailing Address
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Address Line | 188 CHURCH ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-1010
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Country | US
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Telephone | 518-275-7126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | 000248
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License Number State | NY
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