Vandenburgh, Jennifer Anne

Vandenburgh, Jennifer Anne is an individual health care provider with primary practice located at 939 Route 146 Ste 700 , Clifton Park NY 12065-3662. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Vandenburgh, Jennifer Anne can be contacted via phone (518) 383-0891.

Contact Information

Primary practice address
939 Route 146 Ste 700 Clifton Park NY 12065-3662
Phone: (518) 383-0891
Fax: (518) 383-1662
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 022092 New York

Profile Details

NPI number 1548754468
LBN Legal business name Vandenburgh, Jennifer Anne
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2018
Last updated Jun 20th, 2022 - about 2 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 1548754468 NPPES
New York MEDICAID 05205601

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