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1783 Route 9 Suite 102 Halfmoon NY 12065-2409 | |
(518) 383-4198 | |
(518) 383-0448 |
Full Name | |
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Speciality | Internal 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 102 Halfmoon NY 12065-2409 Ph: (518) 383-4198 |
NPI Number | 1003257551 |
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Provider Enumeration Date | 07/12/2013 |
Last Update Date | 08/09/2016 |
Identifier | Type | State | Issuer |
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1003257551 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | 202458 (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 | |