Provider Demographics
NPI:1033936000
Name:COFFEY, JULIET (PA-C)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:COFFEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FRANKLIN SQ APT 1
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2142
Mailing Address - Country:US
Mailing Address - Phone:914-907-8437
Mailing Address - Fax:
Practice Address - Street 1:1003 LOUDON RD STE 101
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-5056
Practice Address - Country:US
Practice Address - Phone:518-786-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032246-01363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant