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Individual

ALICE K DELVENTHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.N.M.

Contact information

Practice address
206 CORNELIA ST, SUITE 202, PLATTSBURGH, NY 12901-2779
(518) 562-7777
(518) 562-7707
Mailing address
206 CORNELIA ST, SUITE 202, PLATTSBURGH, NY 12901-2779
(518) 562-7777
(518) 562-7707

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
F000052-1
NY
363LW0102X
Women's Health Nurse Practitioner
F4207721
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02737933
NY
01
J400020433
MEDICARE PTAN
NY
Enumeration date
04/20/2006
Last updated
10/17/2014
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