Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 241814 | NY |
Y | 208600000X | Surgeon | 241814 | NY |
NPI | 1013018829 |
---|---|
Provider Name | Malene Kay Ingram |
First Address | Schenectady, NY 12304-1009 |
Second Address | Niskayuna, NY 12309-1135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 25/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000412313001 | BSNENY (01) | NY |
061214000250 | FIDELIS CARE (01) | NY |
10115793 | CDPHP (01) | |
2697149 | UHC (01) | NY |
396885 | MVP (01) | NY |
5713U1 | BLUE CROSS (01) | NY |
7708835 | AETNA (01) | NY |
I69696 | (02) | NY |