Mary Ellen Ellen Pace, RN

Individual provider Active NPI Administrator Registered Nurse · Wynantskill, NY

NPI 1982176632 · NPPES record last updated Dec 19, 2018

Key facts

NPI
1982176632
Entity type
Individual (NPI type 1)
Primary specialty
Administrator Registered Nurse 163WA2000X
License
532421 (NY)
Practice address
614 Cooper Hill Rd
Wynantskill, NY 12198-2906
Phone
(518) 283-6500
Fax
(518) 283-0524
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
532421NYMDAdministrator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 532421 NY Yes

Addresses

Primary practice location

614 Cooper Hill Rd
Wynantskill, NY 12198-2906

Mailing address

614 Cooper Hill Rd
Wynantskill, NY 12198-2906
Phone (518) 283-6500

Other providers in Wynantskill, NY

All providers in Wynantskill, NY · Administrator Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.