Basic Information
| Provider Information | |||||||||
| NPI: | 1003221391 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MISCHLER | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 MARYLAND AVE | ||||||||
| Address2: | |||||||||
| City: | COLONIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122054512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7164652095 | ||||||||
| FaxNumber: | 5185804248 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128661090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185838499 | ||||||||
| FaxNumber: | 5185804248 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2014 | ||||||||
| LastUpdateDate: | 07/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 430814 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363L00000X | 430814 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.