person
Mr. Richard J. Desautel, NP
Gerontology Nurse Practitioner in Stuyvesant, New York
NPI 1811194558

Richard J. Desautel is a Gerontology Nurse Practitioner based in Stuyvesant, NY and is specialized in Gerontology. Richard J. Desautel practices in Stuyvesant, NY and has the professional credentials of NP. The NPI Number for Richard J. Desautel is 1811194558 and holds a License No. 004966 (New York).

The current practice location address for Richard J. Desautel is 88 County Route 26A, Stuyvesant, NY and can be reached out via phone at 413-429-5139.

Location: 88 County Route 26A, Stuyvesant, NY, 12173-2410
person
Provider Profile Details
NPI Number
1811194558
Provider Name
Richard J. Desautel
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
88 County Route 26A, Stuyvesant, NY, 12173-2410
Phone Number
413-429-5139
Fax Number
Provider Enumeration Date
06/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
431894499 01 ME MEDICAID - MAINECARE
03213898 05 NY
200213435 01 NY CDPHP
3012611 01 NY MVP
institution
Provider Business Practice Location Address Details
Address
88 County Route 26A
City
State
Zip
12173-2410
Phone Number
413-429-5139
Fax Number
person
Provider Business Mailing Address Details
Address
88 County Route 26A
City
State
Zip
12173-2410
Phone Number
413-429-5139
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
004966 (Connecticut)
Definition
Definition to come...
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