Vanglynn, Mattie M

Vanglynn, Mattie M is an individual health care provider with primary practice located at 550 Harrison St Ste 130, Syracuse NY 13202-3064. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Vanglynn, Mattie M can be contacted via phone (315) 464-4472.

Contact Information

Primary practice address
550 Harrison St Ste 130 Syracuse NY 13202-3064
Phone: (315) 464-4472
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 203991 New York

Profile Details

NPI number 1962407841
LBN Legal business name Vanglynn, Mattie M
Credentials RNNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jul 13th, 2009 - about 15 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 1962407841 NPPES
New York MEDICAID 02058735

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