| New Spruce, Llc | |
|
1150 State Route 23 Catskill NY 12414-5030 | |
| (518) 947-9140 | |
| Not Available |
| Full Name | New Spruce, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1150 State Route 23, Catskill, New York |
| Authorized Official Name and Position | James Weidel (OWNER) |
| Authorized Official Contact | 3057901939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Spruce, Llc 1150 State Route 23 Catskill NY 12414-5030 Ph: (518) 947-9140 | New Spruce, Llc 1150 State Route 23 Catskill NY 12414-5030 Ph: (518) 947-9140 |
| NPI Number | 1689262859 |
|---|---|
| Provider Enumeration Date | 01/04/2021 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Medicare PECOS PAC ID | 8426462698 |
|---|---|
| Medicare Enrollment ID | O20210129000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689262859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | James Weidel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073790564 PECOS PAC ID: 6002992849 Enrollment ID: I20140822002119 |
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