Provider Demographics
NPI:1619737129
Name:HASSELER, LYNN S
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:S
Last Name:HASSELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 FAIRWAY CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1002
Mailing Address - Country:US
Mailing Address - Phone:407-340-9781
Mailing Address - Fax:
Practice Address - Street 1:25 VEEDER DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3619
Practice Address - Country:US
Practice Address - Phone:518-869-4661
Practice Address - Fax:855-298-5311
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY456416163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool