MEDICARE: CLARISSA S WESTNEY MD

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
1	207V00000X	Obstetrics & Gynecology Physician	154393	NY

General Provider Information

NPI Number	:	1508863770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARISSA S WESTNEY MD

Provider Business Mailing Address
First Line	:	PO BOX 11226
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12211-0226
Country	:	US
Telephone Number	:	518-364-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 TROY SCHENECTADY RD
Second Line	:
City	:	NISKAYUNA
State	:	NY
Zip	:	12309-4725
Country	:	US
Telephone Number	:	518-346-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2005
Last Update Date	:	07/18/2012

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