Richard J Portuese, DDS | |
3761 Main St, Warrensburg, NY 12885-1837 | |
(518) 623-3918 | |
(518) 623-4330 |
Full Name | Richard J Portuese |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 3761 Main St, Warrensburg, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568776185 | NPI | - | NPPES |
03294451 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 055052 (New York) | Primary |
Entity Name | Hudson Headwaters Health Network |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194738344 PECOS PAC ID: 7416861208 Enrollment ID: O20031117000239 |
Mailing Address | Practice Location Address |
---|---|
Richard J Portuese, DDS 9 Carey Rd, Queensbury, NY 12804-7880 Ph: (518) 761-0300 | Richard J Portuese, DDS 3761 Main St, Warrensburg, NY 12885-1837 Ph: (518) 623-3918 |
Michelle M Kisiel-cohen, DMD Dentist Medicare: Medicare Enrolled Practice Location: 3761 Main St, Warrensburg, NY 12885 Phone: 518-623-3918 Fax: 518-623-4330 | |
Dr. Raluca Sandler, DDS Dentist Medicare: Medicare Enrolled Practice Location: 3814 Main Street, Warrensburg, NY 12885 Phone: 518-623-3188 Fax: 518-623-3079 | |
Paul V Rizzo, DDS Dentist Medicare: Medicare Enrolled Practice Location: 3761 Main St, Warrensburg, NY 12885 Phone: 518-623-3918 Fax: 518-623-4330 | |
Dr. Steven Arthur Johnson, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3767 Main St, Warrensburg, NY 12885 Phone: 518-623-2844 | |
Erin Down Thompson, DDS Dentist Medicare: Medicare Enrolled Practice Location: 3761 Main St, Warrensburg, NY 12885 Phone: 518-623-3918 Fax: 518-623-4330 |