Provider Demographics
NPI:1720874514
Name:MAGDALENE CARE NP IN PSYCHIATRY AND NP IN FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:MAGDALENE CARE NP IN PSYCHIATRY AND NP IN FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:360-519-6953
Mailing Address - Street 1:418 BROADWAY STE N
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-2922
Mailing Address - Country:US
Mailing Address - Phone:360-519-6953
Mailing Address - Fax:800-752-2534
Practice Address - Street 1:418 BROADWAY STE N
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2922
Practice Address - Country:US
Practice Address - Phone:360-519-6953
Practice Address - Fax:800-752-2534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty