Provider Demographics
NPI:1538977541
Name:UPSTATE ADULT HEALTH NP, PLLC
Entity type:Organization
Organization Name:UPSTATE ADULT HEALTH NP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BLESSING
Authorized Official - Middle Name:
Authorized Official - Last Name:ISIGUZO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:518-512-7681
Mailing Address - Street 1:1764 ROUTE 9 UNIT 674
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-9336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:325 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204-1001
Practice Address - Country:US
Practice Address - Phone:518-512-7681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty