Individual
HEIDI JANE RASMUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1205 TROY SCHENECTADY RD STE 101, LATHAM, NY 12110-1074
(518) 348-3176
Mailing address
PO BOX 304, GLENS FALLS, NY 12801-0304
(518) 686-5002
(518) 686-1848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
190713
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02509328
—
NY
01
—
P00409134
RR MEDICARE
NY
Enumeration date
10/17/2005
Last updated
10/24/2019
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