Individual
MALENE KAY INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2125 RIVER RD, SUITE 302, NISKAYUNA, NY 12309-1135
(518) 243-1313
(518) 831-8007
Mailing address
600 MCCLELLAN ST, SCHENECTADY, NY 12304-1009
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
241814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000412313001
BSNENY
NY
01
—
061214000250
FIDELIS CARE
NY
01
—
10115793
CDPHP
—
01
—
2697149
UHC
NY
01
—
396885
MVP
NY
01
—
5713U1
BLUE CROSS
NY
01
—
7708835
AETNA
NY
Enumeration date
09/26/2006
Last updated
06/25/2014
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