| Alzheimer's Disease Assistance Center | |
|
101 Broad St. Sibley Hall 227 Plattsburgh NY 12901-2681 | |
| (518) 564-3377 | |
| (518) 564-2328 |
| Full Name | Alzheimer's Disease Assistance Center |
|---|---|
| Speciality | Specialist |
| Location | 101 Broad St., Plattsburgh, New York |
| Authorized Official Name and Position | Michael Edwin Simpson (DIRECTOR, SPONSORED RESEARCH & PROG) |
| Authorized Official Contact | 5185642155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alzheimer's Disease Assistance Center 101 Broad St. Sibley 227 Plattsburgh NY 12901-2681 Ph: (518) 564-3377 | Alzheimer's Disease Assistance Center 101 Broad St. Sibley Hall 227 Plattsburgh NY 12901-2681 Ph: (518) 564-3377 |
| NPI Number | 1972718708 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 11/03/2008 |
| Medicare PECOS PAC ID | 3678635067 |
|---|---|
| Medicare Enrollment ID | O20081218000478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972718708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 015955 (New York) | Secondary |
| 174400000X | Specialist | 015955 (New York) | Primary |
| Provider Name | Richard Peter Durant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205146230 PECOS PAC ID: 8022249689 Enrollment ID: I20140324001572 |
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