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NPI Code Detail

MEDICARE: ELEANOR JANE LACLAIR ANP

MEDICARE: ELEANOR JANE LACLAIR ANP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner0024171721VA
2363LA2200XAdult Health Nurse Practitioner304996NY

General Provider Information

NPI Number : 1215186101
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELEANOR JANE LACLAIR ANP
Provider Business Mailing Address
First Line : 133 PARK ST
Second Line :
City : MALONE
State : NY
Zip : 12953-1244
Country : US
Telephone Number : 518-483-3000
Fax Number :
Provider Business Practice Location Address
First Line : 133 PARK ST
Second Line :
City : MALONE
State : NY
Zip : 12953-1244
Country : US
Telephone Number : 518-483-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2008
Last Update Date : 04/06/2023

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Directions to “ ELEANOR JANE LACLAIR ANP” Practice Location

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