Individual
ANDREW LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
123 EVERETT RD, ALBANY, NY 12205
(518) 701-2000
(518) 701-2020
Mailing address
123 EVERETT RD, ALBANY, NY 12205-1407
(518) 701-2000
(518) 701-2020
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
019038-1
NY
363AM0700X
Medical Physician Assistant
Primary
019038
NY
Other
Enumeration date
09/16/2015
Last updated
10/04/2019
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