Individual
PAMELA LUSIGNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13 PALMER AVE, EVERGREEN HEALTH CENTER, CORINTH, NY 12822-1145
(518) 654-6499
(518) 654-7303
Mailing address
PO BOX 304, GLENS FALLS, NY 12801-0304
(518) 654-6499
(518) 654-7303
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F301311
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02327728
—
NY
01
—
J400008218
MEDICARE
NY
01
—
P00812472
RR MEDICARE
NY
Enumeration date
07/30/2006
Last updated
06/25/2012
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