CAROL PHELAN (NPI# 1790881886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790881886 |
| Entity Type | Individual |
| Full Name | CAROL PHELAN |
| Credential | NP |
| Practice Address |
10 Century Hill Dr Latham NY 12110-2162 |
| Practice Telephone | 5187835563 |
| Practice Fax Number | 5187855708 |
| Mailing Telephone | 5187835563 |
| Mailing Fax Number | 5187855708 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F332976 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MVP | 696215 | 01 |
| NY | 02351908 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689950115 | Carol Ann Phelan | Registered Nurse | 45 Brook Ave, Bay Shore, NY 11706-7416 | 2011-10-28 |
| 1538498449 | Carol Anne Phelan | Specialist | 651235a #3 Opelo Road, Kamuela, HI 96743 | 2009-12-24 |
| 1477719862 | Carol Phelan | Optometrist | 25 Elm St, Unit 3, Warwick, NY 10990-1455 | 2008-08-05 |
| Street Address |
10 CENTURY HILL DR |
| City | LATHAM |
| State | NY |
| Zip Code | 12110-2162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699880864 | Henry M. Neilley | Pediatrics | 10 Century Hill Dr, Latham, NY 12110-2162 | 2006-08-20 |
| 1154821247 | Carrie Isensee | Nurse Practitioner | 10 Century Hill Dr, Latham, NY 12110-2162 | 2018-02-15 |
| 1992187223 | Stephanie Guice | Nurse Practitioner | 10 Century Hill Dr, Latham, NY 12110-2162 | 2015-06-23 |
| 1144335324 | Maryla Warszawa-ambros | Pediatrics | 10 Century Hill Dr, Latham, NY 12110-2162 | 2006-08-20 |
| 1881709079 | William A Petersen | Pediatrics | 10 Century Hill Dr, Latham, NY 12110-2162 | 2006-08-20 |
| 1114032125 | Sheela S Graney | Pediatrics | 10 Century Hill Dr, Latham, NY 12110-2162 | 2006-08-20 |
| 1427163435 | David E Sherwood | Pediatrics | 10 Century Hill Dr, Latham, NY 12110-2162 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154963973 | Bayley Archinal | Physical Therapist | 711 Troy-schenectady Road, Ste 216, Latham, NY 12110 | 2019-10-14 |
| 1114410701 | Kimberly A. Hostig Licensed Clinical Social Worker Pllc | Clinic/Center | 8 Stanley Cir Ste 11, Latham, NY 12110 | 2018-06-08 |
| 1710477260 | Colleen Phillips | Physical Therapist | 711 Troy Schenectady Rd Ste 216, Latham, NY 12110 | 2018-05-10 |
| 1528574779 | Deborah Cannon | Specialist | 33c Waterford Avenue East, Latham, NY 12110 | 2017-12-26 |
| 1730600149 | Michael Navarrete | Dentist | 231 Wade Road Ext Unit 101, Latham, NY 12110 | 2017-07-06 |
| 1316499452 | Colonie Asc LLC | Clinic/Center | 207 Troy-schenectady Rd, Colonie, NY 12110 | 2016-10-25 |
| 1720539950 | Tania M Durante | Pharmacist | 1057 Troy-schenectady Rd, Latham, NY 12110 | 2016-10-24 |
| 1417344987 | New York Epilepsy Medicine, PC | Clinic/Center | 3 Lear Jet Ln Ste 203, Latham, NY 12110 | 2015-04-22 |
| 1346664752 | Lauren Gannon | Registered Nurse | 95 Forts Ferry Road, Latham, NY 12110 | 2014-02-06 |
| 1649522756 | Natasha Kapsaroff-ruiz | Nurse Practitioner | 654 Watervliet Shaker Rd, Latham, NY 12110 | 2012-10-12 |
| Find all providers in zip 12110 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487279774 | Niccole Davey | Nurse Practitioner | 38a Old Sparrowbush Rd, Latham, NY 12110-2927 | 2020-06-11 |
| 1992340749 | Gina C Ptak | Nurse Practitioner | 582 New Loudon Rd Ste 6, Latham, NY 12110-4029 | 2019-11-14 |
| 1649522756 | Natasha Kapsaroff-ruiz | Nurse Practitioner | 654 Watervliet Shaker Rd, Latham, NY 12110 | 2012-10-12 |
| 1639784523 | Eric Golderman | Nurse Practitioner | 8 Century Hill Dr, Latham, NY 12110-2193 | 2020-09-09 |
| 1922634757 | Heather Lynn Maggio | Nurse Practitioner | 711 Troy Schenectady Rd Ste 202, Latham, NY 12110-2461 | 2020-03-12 |
| 1265066864 | Anita Puthuparampil-suchdeve | Nurse Practitioner | 713 Troy Schenectady Rd Ste 125, Latham, NY 12110-2490 | 2020-02-24 |
| 1063987915 | April Marie St. Peter | Nurse Practitioner | 7b Johnson Rd, Latham, NY 12110-3003 | 2018-10-08 |
| 1972085819 | Donnamarie Elizabeth Martocci | Nurse Practitioner | 711 Troy Schenectady Rd Ste 104, Latham, NY 12110-2454 | 2018-09-06 |
| 1518449677 | Kathleen M Ryan | Nurse Practitioner | 1205 Troy Schenectady Rd Ste 101, Latham, NY 12110-1074 | 2018-09-05 |
| 1710465299 | Amy Nellie Lane | Nurse Practitioner | 8 Century Hill Dr, Latham, NY 12110-2193 | 2018-08-06 |
| Find all providers in LATHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.