| |
283 Mountain View Rd Copake NY 12516-1201 | |
(518) 329-3902 | |
(518) 329-3903 |
Full Name | |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 283 Mountain View Rd, Copake, New York |
Authorized Official Name and Position | Bryan Mahoney (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 5188288249 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2000 Hudson NY 12534-2000 Ph: (518) 828-8051 | 283 Mountain View Rd Copake NY 12516-1201 Ph: (518) 329-3902 |
NPI Number | 1073960225 |
---|---|
Provider Enumeration Date | 05/18/2016 |
Last Update Date | 05/18/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073960225 | NPI | - | NPPES |
03227290 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 1001000H (New York) | Primary |