Alden Medical Group, Pllc | |
12845 Broadway Alden NY 14004-1223 | |
(716) 937-3255 | |
(716) 204-7481 |
Full Name | Alden Medical Group, Pllc |
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Speciality | Internal Medicine |
Location | 12845 Broadway, Alden, New York |
Authorized Official Name and Position | Yellamraju R Kumar (PARTNER) |
Authorized Official Contact | 7169373255 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Alden Medical Group, Pllc 12845 Broadway Alden NY 14004-1223 Ph: (716) 937-3255 | Alden Medical Group, Pllc 12845 Broadway Alden NY 14004-1223 Ph: (716) 937-3255 |
NPI Number | 1912931650 |
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Provider Enumeration Date | 07/10/2006 |
Last Update Date | 06/25/2015 |
Medicare PECOS PAC ID | 7113998162 |
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Medicare Enrollment ID | O20040803001251 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912931650 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (New York) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (New York) | Primary |
Provider Name | Venkata R Jupudy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285690008 PECOS PAC ID: 0941295893 Enrollment ID: I20040419001392 |
Provider Name | Yellamraju R Kumar |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326004649 PECOS PAC ID: 0648241604 Enrollment ID: I20040804001681 |
Provider Name | Thomas Francis Hughes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518928290 PECOS PAC ID: 4385547595 Enrollment ID: I20050623000579 |
Provider Name | Amy Lynn Baun |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851469191 PECOS PAC ID: 6608974902 Enrollment ID: I20070611000453 |
Provider Name | Ashley Iten |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770904195 PECOS PAC ID: 4183846652 Enrollment ID: I20141118000914 |
Provider Name | Preeti Shashi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1386273902 PECOS PAC ID: 9032561196 Enrollment ID: I20240115000854 |