Provider Demographics
NPI:1033108550
Name:STRAEBLER, MARY ELLEN (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARY ELLEN
Middle Name:
Last Name:STRAEBLER
Suffix:
Gender:F
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:914-734-8800
Mailing Address - Fax:914-734-8808
Practice Address - Street 1:75 ORANGE AVE
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1816
Practice Address - Country:US
Practice Address - Phone:845-778-2700
Practice Address - Fax:845-778-2945
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF332368-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02328825Medicaid
NYA400059635Medicare PIN