Basic Information
| Provider Information | |||||||||
| NPI: | 1497789184 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOULIHAN | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | NP/PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1462 ERIE BLVD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123051026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182431500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1101 NOTT ST | ||||||||
| Address2: | |||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123082425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182434000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 07/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 231831 | NY | N | Nursing Service Providers | Registered Nurse | General Practice | 363AM0700X | 002769 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363LA2200X | 300443 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 000496509001 | 01 | NY | BLUE SHIELD | OTHER | 787905 | 01 | NY | MVP | OTHER | 050803000023 | 01 | NY | FIDELIS CARE | OTHER | 7599221 | 01 | NY | GHI-PPO | OTHER | 000000069211 | 01 | NY | GHI-HMO | OTHER |