Adirondack Cross Roads Psychology Pllc | |
123 Dixon Rd Queensbury NY 12804-2133 | |
(518) 798-2088 | |
(518) 798-2088 |
Full Name | Adirondack Cross Roads Psychology Pllc |
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Speciality | Psychologist |
Location | 123 Dixon Rd, Queensbury, New York |
Authorized Official Name and Position | Paul Gerard Schulze (ORIGINAL MANAGER/ OWNER) |
Authorized Official Contact | 5187982088 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Adirondack Cross Roads Psychology Pllc 123 Dixon Rd Queensbury NY 12804-2133 Ph: (518) 798-2088 | Adirondack Cross Roads Psychology Pllc 123 Dixon Rd Queensbury NY 12804-2133 Ph: (518) 798-2088 |
NPI Number | 1528378692 |
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Provider Enumeration Date | 10/07/2010 |
Last Update Date | 10/07/2010 |
Medicare PECOS PAC ID | 6507046109 |
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Medicare Enrollment ID | O20221021000207 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528378692 | NPI | - | NPPES |
137679 | Other | NY | VALUE OPTIONS |
VE9702 | Other | NY | EMPIRE BLUE CROSS BLUE SHIELD |
200207781 | Other | NY | CDPHP |
41202 | Other | NY | MVP |
01675901 | Medicaid | NY | |
000405218002 | Other | NY | BLUE SHIELD OF NORTHEASTERN NEW YORK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 010511 (New York) | Primary |
Provider Name | Paul G Schulze |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1952493538 PECOS PAC ID: 2264569441 Enrollment ID: I20100420000382 |
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