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Individual

MS. TINA FACTEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSN,RN,CDE

Contact information

Practice address
102 PARK ST, 3RD FLOOR PRUYN PAVILION, GLENS FALLS, NY 12801-4449
(518) 926-2610
(518) 926-2091
Mailing address
102 PARK ST, 3RD FLOOR PRUYN PAVILION, GLENS FALLS, NY 12801
(518) 926-2610
(518) 926-2091

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
442838
NY

Other

Enumeration date
02/25/2009
Last updated
02/25/2009
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