KIM P GENDRON FNP NPI 1053404061

NPI Information

NPI: 1053404061
Provider Name: KIM P GENDRON, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
315 S MANNING BLVD
ALBANY, NY
ZIP 12208
Phone: (518) 279-5700
Get Directions

Kim P Gendron, FNP is a family nurse practitioner in Albany, NY with 27 years of experience. Kim P Gendron, FNP NPI is 1053404061. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

315 S MANNING BLVD
ALBANY, NY
ZIP 12208-707
Phone: (518) 279-5700
Fax: (518) 270-1323

The NPI 1053404061 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 4/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		331800	NEW YORK	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	F401277	NEW YORK	No
3	363LF0000X	Nurse Practitioner	Family	331800	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02327719	MEDICAID	NEW YORK
2	P00466853	OTHER	NEW YORK	RR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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