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General NPI Number Information
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NPI Number | 1942878350
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Entity Type | Organization
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Legal Business Name | LATHAM PSYCHIATRIC NP CARE
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Dates
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Enumeration Date | 06/12/2021
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Last Update Date | 06/12/2021
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Provider Practice Location Address
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Address Line | MALTA COMMONS BUISNESS PARK 100 SARATOGA VILLIAGE BLVD BUILDING 37, SUITE 37
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City | MALTA
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State | NY
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Zip | 12020
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Country | US
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Telephone | 518-795-2400
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Fax |
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Provider Business Mailing Address
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Address Line | MALTA COMMONS BUISNESS PARK 100 SARATOGA VILLIAGE BLVD BUILDING 37, SUITE 37
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City | MALTA
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State | NY
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Zip | 12020
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Country | US
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Telephone | 518-795-2400
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Fax |
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Authorized Official
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Title or Position | DNP FNP PMHNP-BC
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Name | JANET YAGER
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Credential |
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Telephone | 518-867-7869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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