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289 Mcfadden Rd Apalachin NY 13732-3808 | |
(607) 761-7782 | |
Not Available |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 289 Mcfadden Rd, Apalachin, New York |
Authorized Official Name and Position | Kristin Condie (OWNER) |
Authorized Official Contact | 6077617782 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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289 Mcfadden Rd Apalachin NY 13732-3808 Ph: (607) 761-7782 | 289 Mcfadden Rd Apalachin NY 13732-3808 Ph: (607) 761-7782 |
NPI Number | 1528689585 |
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Provider Enumeration Date | 04/30/2020 |
Last Update Date | 01/19/2021 |
Certification Date | 01/19/2021 |
Medicare PECOS PAC ID | 2961816525 |
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Medicare Enrollment ID | O20210122001742 |
Identifier | Type | State | Issuer |
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1528689585 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Kristin Schoeberlein Condie |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1013197086 PECOS PAC ID: 8123306818 Enrollment ID: I20161101000433 |