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General NPI Number Information
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NPI Number | 1669819728
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Entity Type | Organization
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Legal Business Name | GLENS FALLS
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 102 PARK ST STE 3
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City | GLENS FALLS
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State | NY
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Zip | 12801-4449
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Country | US
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Telephone | 518-926-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 102 PARK ST STE 3
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City | GLENS FALLS
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State | NY
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Zip | 12801-4449
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Country | US
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Telephone | 518-926-2613
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Fax |
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Authorized Official
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Title or Position | DIABETIC NURSE EDUCATOR
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Name | MS. JILL M DIDIO
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Credential | RN
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Telephone | 518-929-2613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 397457
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License Number State | NY
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