Individual
DANA VANDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2233 STATE ROUTE 86, SARANAC LAKE, NY 12983-5644
(518) 897-2317
(518) 897-2423
Mailing address
2233 STATE ROUTE 86, P.O. BOX 1380, SARANAC LAKE, NY 12983-5644
(518) 897-2317
(518) 897-2423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005887
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00363213
—
NY
01
—
005887
LICENSE
NY
Enumeration date
06/04/2007
Last updated
07/09/2007
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