1164169694 NPI number — MARY E VANALSTYNE NURSE PRACTITIONER IN FAMILY HEALTH PC

Table of content: DR. ANDREW H. TSCHEPPE D.C. (NPI 1336264738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164169694 NPI number — MARY E VANALSTYNE NURSE PRACTITIONER IN FAMILY HEALTH PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARY E VANALSTYNE NURSE PRACTITIONER IN FAMILY HEALTH PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164169694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 CHELSEA PL STE 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12065-3236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-763-7701
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 CHELSEA PL STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLIFTON PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12065-3236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-763-7701
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2022

Additional Information

Authorized Official

Authorized Official Last Name:
VANALSTYNE
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
NP
Authorized Official Telephone Number:
518-763-7701

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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