Provider Demographics
NPI:1073274510
Name:LAWSON, DANIELLE (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155A SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4223
Mailing Address - Country:US
Mailing Address - Phone:518-796-4071
Mailing Address - Fax:
Practice Address - Street 1:7 SOUTHWOODS BLVD STE 17
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2564
Practice Address - Country:US
Practice Address - Phone:518-292-6035
Practice Address - Fax:518-292-6005
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty