Pericak, Arlene
Pericak, Arlene is an individual health care provider with primary practice located at 942A Route 146 , Clifton Park NY 12065-3614. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Pericak, Arlene can be contacted via phone (518) 371-8000.Contact Information
Primary practice address
942A Route 146
Clifton Park NY 12065-3614
Phone: (518) 371-8000
Fax: (518) 371-5338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | F330373-1 | New York |
Profile Details
| NPI number | 1225055890 |
|---|---|
| LBN Legal business name | Pericak, Arlene |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jul 5th, 2012 - about 14 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 | 1225055890 | NPPES |
| New York | Other | 671204 | GHI-HMO |
| New York | Other | 120118000008 | GHI-HMO |
| New York | MEDICAID | 02408120 | GHI-HMO |
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