Bergen-Chagnon, Mary Brita

Bergen-Chagnon, Mary Brita is an individual health care provider with primary practice located at 47 New Scotland Ave , Albany NY 12208-3412. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Bergen-Chagnon, Mary Brita can be contacted via phone (518) 262-4300.

Contact Information

Primary practice address
47 New Scotland Ave Albany NY 12208-3412
Fax: (518) 262-4736
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 117019 New York

Profile Details

NPI number 1154321552
LBN Legal business name Bergen-Chagnon, Mary Brita
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Jul 8th, 2007 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154321552 NPPES
New York MEDICAID 00451203

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