Provider Demographics
NPI:1427897628
Name:PARKER WELLS WOMEN'S SHELTER
Entity type:Organization
Organization Name:PARKER WELLS WOMEN'S SHELTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRTECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ETOTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:220-221-7818
Mailing Address - Street 1:434 STATE STREET MAIN FLOOR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12307
Mailing Address - Country:US
Mailing Address - Phone:220-221-7818
Mailing Address - Fax:
Practice Address - Street 1:434 STATE STREET MAIN FLOOR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12307
Practice Address - Country:US
Practice Address - Phone:220-221-7818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty