Provider Demographics
NPI:1295846905
Name:LARNER, VIRGINIA B (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:B
Last Name:LARNER
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1925 CURRY RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-3939
Practice Address - Country:US
Practice Address - Phone:518-356-5377
Practice Address - Fax:518-881-1489
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY008518363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000499152001OtherBSNENY
NY02246151Medicaid
NY070418000012OtherFIDELIS
NY082300OtherMVP HEALTHCARE
NYCC8203Medicare ID - Type Unspecified
NY02246151Medicaid