Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 300509 | NY |
NPI | 1033234943 |
---|---|
Provider Name | Cynthia A Altieri |
First Address | Holland Patent, NY 13354-3558 |
Second Address | Utica, NY 13502-3854 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300509 | (05) | NY |
OTH000 | (02) | NY |