Individual
HEIDI H VANDEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
241 STEELE AVE, GLOVERSVILLE, NY 12078
(518) 725-4414
(518) 725-4414
Mailing address
2219 ST HWY 67, JOHNSTOWN, NY 12095
(518) 762-5035
(518) 725-4414
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
400586
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
345316
MVP
NY
Enumeration date
12/01/2006
Last updated
07/08/2007
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