Provider Demographics
NPI:1477552032
Name:MINCOLLA, RHONDA (CRNA)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:MINCOLLA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:102 HACKETT BLVD
Mailing Address - Street 2:ANESTHESIA GROUP OF ALBANY, PC
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1543
Mailing Address - Country:US
Mailing Address - Phone:518-463-0060
Mailing Address - Fax:518-436-0699
Practice Address - Street 1:102 HACKETT BLVD
Practice Address - Street 2:ANESTHESIA GROUP OF ALBANY, PC
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209-1543
Practice Address - Country:US
Practice Address - Phone:518-463-0060
Practice Address - Fax:518-436-0699
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024177142367500000X
NY404472367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD6941Medicare ID - Type Unspecified