Provider Demographics
NPI:1275524217
Name:STEFANATOS, ANGELA GARCIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:GARCIA
Last Name:STEFANATOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 UNION STREET SILLIMAN HALL
Mailing Address - Street 2:UNION COLLEGE
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-388-6120
Mailing Address - Fax:518-388-6147
Practice Address - Street 1:807 UNION STREET SILLIMAN HALL
Practice Address - Street 2:UNION COLLEGE
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308
Practice Address - Country:US
Practice Address - Phone:518-388-6120
Practice Address - Fax:518-388-6147
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP35119Medicare UPIN