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General NPI Number Information
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NPI Number | 1538977541
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Entity Type | Organization
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Legal Business Name | UPSTATE ADULT HEALTH NP, PLLC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 325 NORTHERN BLVD
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City | ALBANY
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State | NY
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Zip | 12204-1001
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Country | US
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Telephone | 518-512-7681
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Fax |
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Provider Business Mailing Address
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Address Line | 1764 ROUTE 9 UNIT 674
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City | HALFMOON
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State | NY
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Zip | 12065-9336
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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 | NURSE PRACTITIONER/DIRECTOR
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Name | DR. BLESSING ISIGUZO
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Credential | DNP
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Telephone | 518-512-7681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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