Individual
MRS. ELLEN A. BRIGNOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 TALLOW WOOD DR, CLIFTON PARK, NY 12065-2807
(518) 373-4444
(518) 373-0663
Mailing address
1 TALLOW WOOD DRIVE, CLIFTON PARK, NY 12065
(518) 373-4444
(518) 373-0663
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
336354
NY
363L00000X
Nurse Practitioner
Primary
F336354
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03263650
—
NY
01
—
101209000118
FIDELIS
NY
01
—
3014370
MVP HEALTHCARE
NY
01
—
307090
SENIOR WHOLE HEALTH
NY
01
—
644141
GHI/HMO
NY
Enumeration date
09/21/2010
Last updated
10/31/2016
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