Phelan, Carol

Phelan, Carol is an individual health care provider with primary practice located at 10 Century Hill Dr , Latham NY 12110-2162. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Phelan, Carol can be contacted via phone (518) 783-5563.

Contact Information

Primary practice address
10 Century Hill Dr Latham NY 12110-2162
Phone: (518) 783-5563
Fax: (518) 785-5708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F332976 New York

Profile Details

NPI number 1790881886
LBN Legal business name Phelan, Carol
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Jul 8th, 2007 - about 19 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 1790881886 NPPES
New York Other 696215 MVP
New York MEDICAID 02351908 MVP

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