Provider Demographics
NPI:1932245594
Name:VANANDEN, ELIZABETH GARBER (PA-C)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:GARBER
Last Name:VANANDEN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2249 STATE ROUTE 86
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5644
Mailing Address - Country:US
Mailing Address - Phone:518-891-3845
Mailing Address - Fax:
Practice Address - Street 1:2249 STATE ROUTE 86
Practice Address - Street 2:SUITE 3
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5644
Practice Address - Country:US
Practice Address - Phone:518-891-3845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY002038-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical