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Organization
UPSTATE WELLNESS AND AESTHETIC SERVICES
Active
Organization
UPSTATE WELLNESS AND AESTHETIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE ELROY CHAN NP (CEO)
(518) 428-8610
Entity
Organization
Contact information
Practice address
200 WASHINGTON AVENUE EXT, ALBANY, NY 12203-5394
(518) 456-2000
Mailing address
99 WALL ST STE 2071, NEW YORK, NY 10005-4301
(518) 428-8610
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/24/2026
Last updated
01/24/2026
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