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1783 Route 9 Suite 204 Halfmoon NY 12065-2409 | |
(518) 371-9355 | |
(518) 373-9139 |
Full Name | |
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Speciality | Family Medicine |
Location | 1783 Route 9, Halfmoon, New York |
Authorized Official Name and Position | Diane M Stamas (SENIOR CREDENTIALING COORDINATOR) |
Authorized Official Contact | 5187823742 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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711 Troy Schenectady Rd Suite 203 Latham NY 12110-2442 Ph: (518) 782-3700 | 1783 Route 9 Suite 204 Halfmoon NY 12065-2409 Ph: (518) 371-9355 |
NPI Number | 1770867103 |
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Provider Enumeration Date | 10/04/2011 |
Last Update Date | 08/24/2016 |
Identifier | Type | State | Issuer |
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1770867103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 184866 (New York) | Primary |
Ellis Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Sitterly Rd Ste 2200, Halfmoon, NY 12065 Phone: 518-243-3311 | |