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Brooke A Raveendranath, NP
Pediatric Nurse Practitioner in Albany, New York
NPI 1891849618

Brooke A Raveendranath is a Pediatric Nurse Practitioner based in Albany, NY and is specialized in Pediatrics. Brooke A Raveendranath practices in Albany, NY and has the professional credentials of NP. The NPI Number for Brooke A Raveendranath is 1891849618 and holds a License No. 381788 (New York).

The current practice location address for Brooke A Raveendranath is 6 Executive Park Dr, Albany, NY and can be reached out via phone at 518-641-6319 and via fax at 518-641-6850. You can also correspond with Brooke A Raveendranath through the mailing address at PO BOX 14890, ALBANY, NY - 12212-4890 (mailing address contact number: 518-525-5634).

Location: 6 Executive Park Dr, Albany, NY, 12212-4890
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Provider Profile Details
NPI Number
1891849618
Provider Name
Brooke A Raveendranath
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
6 Executive Park Dr, Albany, NY, 12212-4890
Phone Number
518-641-6319
Fax Number
518-641-6850
Provider Enumeration Date
01/22/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02848268 05 NY
000420465001 01 NY BSNENY
3010992 01 NY MVP HEALTHCARE
143259 01 NY GHI-HMO
091210000047 01 NY FIDELIS
institution
Provider Business Practice Location Address Details
Address
6 Executive Park Dr
City
State
Zip
12203-3791
Phone Number
518-641-6319
Fax Number
518-641-6850
person
Provider Business Mailing Address Details
Address
Po Box 14890
City
State
Zip
12212-4890
Phone Number
518-525-5634
Fax Number
518-649-4094
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
381788 (New York)
Definition
Definition to come...
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