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Individual

CLAUDIANUS H BOURNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
407 ALBANY SHAKER RD STE 100, LOUDONVILLE, NY 12211-1962
(518) 435-1300
(518) 435-1397
Mailing address
PO BOX 1081, TROY, NY 12181-1081
(518) 791-9607

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F337303
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02995513
NY
Enumeration date
07/18/2012
Last updated
07/29/2024
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