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General NPI Number Information
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NPI Number | 1558812297
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Entity Type | Organization
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Legal Business Name | OBERG PSYCHIATRIC NURSE PRACTITIONER, PLLC
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 855 ROUTE 146 STE 104
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3890
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Country | US
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Telephone | 518-630-6547
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Fax | 518-303-5157
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Provider Business Mailing Address
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Address Line | 16 LAKEVIEW RD
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City | SARATOGA SPGS
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State | NY
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Zip | 12866-8705
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Country | US
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Telephone | 518-669-7434
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Fax | 518-871-1265
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Authorized Official
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Title or Position | OWNER
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Name | LISA OBERG
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Credential | NPP
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Telephone | 518-669-7434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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