Black, Mandy Beth

Black, Mandy Beth is an individual health care provider with primary practice located at 279 Troy Rd , Rensselaer NY 12144-9518. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Black, Mandy Beth can be contacted via phone (518) 286-1922.

Contact Information

Primary practice address
279 Troy Rd Rensselaer NY 12144-9518
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 339091 New York

Profile Details

NPI number 1386049385
LBN Legal business name Black, Mandy Beth
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2014
Last updated May 2nd, 2023 - about last year

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 1386049385 NPPES
New York MEDICAID 03993955

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