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NPI Code Detail

MEDICARE: RICHARD A PATENAUDE JR.

MEDICARE: RICHARD A PATENAUDE JR.
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 Nurse543450-1NY

General Provider Information

NPI Number : 1417212861
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD A PATENAUDE JR.
Provider Business Mailing Address
First Line : 87 WASHINGTON ST
Second Line : PO BOX 148
City : RENSSELAER
State : NY
Zip : 12144
Country : US
Telephone Number : 518-449-1142
Fax Number : 518-449-1320
Provider Business Practice Location Address
First Line : 87 WASHINGTON ST
Second Line :
City : RENSSELAER
State : NY
Zip : 12144-2613
Country : US
Telephone Number : 518-449-1142
Fax Number : 518-449-1320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2012
Last Update Date : 02/22/2026

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