Basic Information
| Provider Information | |||||||||
| NPI: | 1477763050 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMOND | ||||||||
| FirstName: | WILMA | ||||||||
| MiddleName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE BROAD ST. PLAZA | ||||||||
| Address2: | |||||||||
| City: | GLENS FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187610300 | ||||||||
| FaxNumber: | 5187451378 | ||||||||
| Practice Location | |||||||||
| Address1: | 3767 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WARRENSBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128851837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186232844 | ||||||||
| FaxNumber: | 5186233416 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD0400X | 500514 | NY | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No ID Information.