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Individual

MARIJKE B ORMEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
2233 STATE ROUTE 86, SARANAC LAKE, NY 12983-5644
(518) 891-4141
(518) 897-2788
Mailing address
173 KIWASSA RD, SARANAC LAKE, NY 12983-2356
(518) 891-0078
(518) 897-2423

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
304917
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00363213
NY
01
1245446533
GROUP NPI
NY
01
141731786
TAX ID
NY
Enumeration date
09/23/2008
Last updated
10/06/2008
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