Individual
MRS. LAUREN GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 FORTS FERRY ROAD, LATHAM, NY 12110
(518) 785-9203
Mailing address
95 FORTS FERRY ROAD, LATHAM, NY 12110
(518) 785-9203
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
590295
NY
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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