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Individual

AMY L HETTRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
848 ROUTE 50, BURNT HILLS, NY 12027
(518) 831-1500
(518) 377-1677
Mailing address
PO BOX 569, 848 ROUTE 50, BURNT HILLS, NY 12027-0569
(518) 831-1500
(518) 377-1677

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005898
NY
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
005898
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02554974
NY
Enumeration date
11/01/2006
Last updated
03/16/2017
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