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NPI Code Detail

MEDICARE: NATHANIEL AYOTTE ATC

MEDICARE:   NATHANIEL  AYOTTE  ATC
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
12255A2300XAthletic TrainerAT002060GA
22255A2300XAthletic Trainer003004-01NY

General Provider Information

NPI Number : 1508257429
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL AYOTTE ATC
Provider Business Mailing Address
First Line : 13 SUFFOLK LN
Second Line :
City : GANSEVOORT
State : NY
Zip : 12831-1379
Country : US
Telephone Number : 207-230-4829
Fax Number :
Provider Business Practice Location Address
First Line : 815 N BROADWAY
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-1632
Country : US
Telephone Number : 518-580-5397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2015
Last Update Date : 01/03/2026

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Directions to “ NATHANIEL AYOTTE ATC” Practice Location

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