Provider Demographics
NPI:1275522260
Name:NADEAU, ANNA (NP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:NADEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10121
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-5121
Mailing Address - Country:US
Mailing Address - Phone:518-886-5800
Mailing Address - Fax:518-886-5805
Practice Address - Street 1:3050 ROUTE 50 NORTH
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2958
Practice Address - Country:US
Practice Address - Phone:518-886-5800
Practice Address - Fax:518-886-5805
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303730363LA2200X
NY334796363LF0000X
NY334796-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02517559Medicaid
NYJ400001272Medicare PIN
NY02517559Medicaid
NY1929G1Medicare PIN