| Doctor Name: | MARY DIANE RADLIFF |
| NPI Number: | 1831259514 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | 30-301409 |
| Business Practice Address: | 130 Albany Ave Cobleskill, NY - 12043 |
| Business Phone Number: | 5182555225 |
| Business Fax Number: | 5182555819 |
| Mailing Address: | 130 Albany Ave, COBLESKILL |
| State: | NY |
| Postal Code: | 12043 |
| Phone Number: | 5182555225 |
| Fax Number: | 5182555819 |
| NPI Enumeration Date: | 12/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 30-301409 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |