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13 Chester Street, Glen Falls, NY 12801 | |
(518) 223-0331 | |
(518) 223-0331 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 13 Chester Street, Glen Falls, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1508165580 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 010161 (New York) | Primary |
261QH0100X | Clinic/center - Health Service | 010161 (New York) | Secondary |
Provider Name | Chad Derrick Macnaughton |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1376625079 PECOS PAC ID: 9830298454 Enrollment ID: I20070622000354 |
Provider Name | Chad Derrick Macnaughton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376625079 PECOS PAC ID: 9830298454 Enrollment ID: I20230509000739 |
Mailing Address | Practice Location Address |
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13 Chester Street, Glen Falls, NY 12801 Ph: (518) 223-0331 | 13 Chester Street, Glen Falls, NY 12801 Ph: (518) 223-0331 |