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NPI Code Detail

MEDICARE: MARILYN VON DOLLEN NP IN PSYCHIATRY LLC

MEDICARE: MARILYN VON DOLLEN NP IN PSYCHIATRY LLC
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
1251S00000XCommunity/Behavioral Health AgencyF400457-1NY

General Provider Information

NPI Number : 1407038938
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARILYN VON DOLLEN NP IN PSYCHIATRY LLC
Provider Business Mailing Address
First Line : 1471 WESTERN AVE
Second Line :
City : ALBANY
State : NY
Zip : 12203-3512
Country : US
Telephone Number : 518-453-2280
Fax Number : 518-453-2282
Provider Business Practice Location Address
First Line : 1471 WESTERN AVE
Second Line :
City : ALBANY
State : NY
Zip : 12203-3512
Country : US
Telephone Number : 518-453-2280
Fax Number : 518-453-2282
Authorized Official
Title or Position : NURSE PRACTITIONER IN PSYCHIATRY
Name : MS. MARILYN ANNE VON DOLLEN
Credential : RN,MS,NPP
Telephone Number : 518-453-2280
Provider Enumeration Date : 11/27/2007
Last Update Date : 07/01/2008

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Directions to “MARILYN VON DOLLEN NP IN PSYCHIATRY LLC ” Practice Location

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