Provider Demographics
NPI:1346281664
Name:YAMIN, MARY CHRISTINE (MSN /FNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:YAMIN
Suffix:
Gender:F
Credentials:MSN /FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LANSING AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-4828
Mailing Address - Country:US
Mailing Address - Phone:518-274-5640
Mailing Address - Fax:518-274-5646
Practice Address - Street 1:200 BROADWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-3289
Practice Address - Country:US
Practice Address - Phone:518-274-5642
Practice Address - Fax:518-274-5646
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330391-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily