Individual
ANGELA MEMMELAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2125 RIVER RD, SUITE 303, SCHENECTADY, NY 12309-1135
(518) 382-8350
(518) 382-0345
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306051
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03494497
—
NY
01
—
121109000005
FIDELIS CARE NY
NY
Enumeration date
08/13/2012
Last updated
01/26/2018
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