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NPI Code Detail

MEDICARE: CHARLENE ANN STELLUTI DNP, FNP

MEDICARE: CHARLENE ANN STELLUTI DNP, FNP
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
1163W00000XRegistered Nurse688822NY
2363LF0000XFamily Nurse Practitioner344935NY

General Provider Information

NPI Number : 1346892239
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLENE ANN STELLUTI DNP, FNP
Provider Business Mailing Address
First Line : 6 WELLNESS WAY STE 201
Second Line :
City : LATHAM
State : NY
Zip : 12110-2156
Country : US
Telephone Number : 518-782-3700
Fax Number : 518-782-3799
Provider Business Practice Location Address
First Line : 6 WELLNESS WAY STE 114
Second Line :
City : LATHAM
State : NY
Zip : 12110-2467
Country : US
Telephone Number : 518-785-5881
Fax Number : 518-785-1574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2019
Last Update Date : 11/05/2025

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