Black, Mandy Beth
Black, Mandy Beth is an individual health care provider with primary practice located at 279 Troy Rd , Rensselaer NY 12144-9518. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Black, Mandy Beth can be contacted via phone (518) 286-1922.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 339091 | New York |
Profile Details
| NPI number | 1386049385 |
|---|---|
| LBN Legal business name | Black, Mandy Beth |
| Credentials | FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2014 |
| Last updated | May 2nd, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386049385 | NPPES |
| New York | MEDICAID | 03993955 |
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