Provider Demographics
NPI:1831461425
Name:MOLINARY, ADAM (LPN)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:MOLINARY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1588 ALBANY POST RD
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:NY
Mailing Address - Zip Code:12525-5520
Mailing Address - Country:US
Mailing Address - Phone:845-926-4045
Mailing Address - Fax:
Practice Address - Street 1:1588 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:NY
Practice Address - Zip Code:12525-5520
Practice Address - Country:US
Practice Address - Phone:845-926-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304858164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03411305Medicaid