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Individual

C LYNN VAN ANTWERPEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
314 S MANNING BLVD, ALBANY, NY 12208-1708
(518) 453-2273
Mailing address
314 S MANNING BLVD, ALBANY, NY 12208-1708

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
165112
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00165112
NY
01
10002994
CDPHP
01
13833
MVP
Enumeration date
05/27/2006
Last updated
03/11/2008
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