Autumn House, LDO

NPI 1790651867 · on the registry since 2025 · sole proprietor

Practice

Address: 139 Merchant Pl
Cobleskill, NY 12043
Phone: (518) 234-1155
Fax: (518) 254-0691
Organisation at this address: Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 156FX1800X
156FX1800X
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2025-10-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York