Provider Demographics
NPI:1275638959
Name:VANDEPOL, MARIA E (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:VANDEPOL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:RIMASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 CARE LN
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8624
Practice Address - Country:US
Practice Address - Phone:518-587-7625
Practice Address - Fax:518-587-0273
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY430060363L00000X
NYF430060-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC1531Medicare PIN
NYP11964Medicare UPIN