Larsen, William

Larsen, William is an sole proprietor health care provider with primary practice located at 905 Hanshaw Rd , Ithaca NY 14850-1549. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Larsen, William can be contacted via phone (607) 339-0670.

Contact Information

Primary practice address
905 Hanshaw Rd Ithaca NY 14850-1549
Phone: (607) 339-0670
Fax: (607) 319-5524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 339752 New York

Profile Details

NPI number 1124409099
LBN Legal business name Larsen, William
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2015
Last updated Aug 23rd, 2022 - about 4 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 1124409099 NPPES
New York Other 2734852 MEDICAID GROUP
New York Other 1088 MEDICAID GROUP
New York MEDICAID 04173960 MEDICAID GROUP

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