Individual
PAMELA PROULX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3649
(607) 547-4648
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3649
(607) 547-4648
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
553188-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
N/A
NY
01
—
N/A
N/A
—
Enumeration date
06/09/2015
Last updated
06/09/2015
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