Provider Demographics
NPI:1265771299
Name:FAMILY NURSE PRACTITIONER AND CERTIFIED NURSE MIDWIVES OF MALTA, PLLC
Entity type:Organization
Organization Name:FAMILY NURSE PRACTITIONER AND CERTIFIED NURSE MIDWIVES OF MALTA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:CIAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:518-793-9820
Mailing Address - Street 1:46 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3524
Mailing Address - Country:US
Mailing Address - Phone:518-793-9820
Mailing Address - Fax:
Practice Address - Street 1:46 ELM ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3524
Practice Address - Country:US
Practice Address - Phone:518-793-9820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty