Provider Demographics
NPI:1013398106
Name:HUNEKE, MAEGAN (PMHNP)
Entity Type:Individual
Prefix:MISS
First Name:MAEGAN
Middle Name:
Last Name:HUNEKE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4383
Mailing Address - Country:US
Mailing Address - Phone:518-480-4002
Mailing Address - Fax:518-409-4916
Practice Address - Street 1:92 BROAD ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4383
Practice Address - Country:US
Practice Address - Phone:518-480-4002
Practice Address - Fax:518-409-4916
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY653751163W00000X
NY404980363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY653751OtherNYS LISCENSE
NY404980OtherNYS NP LISCENSE