Individual
DIANNA HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
84 E STATE ST, GLOVERSVILLE, NY 12078-1202
(518) 332-1351
Mailing address
425 W STATE ST EXT, GLOVERSVILLE, NY 12078-6213
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
354482
NY
Other
Enumeration date
08/03/2024
Last updated
08/03/2024
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