| Coppernoll Medical Practice Pllc | |
|
101 Madison Ave Wampsville NY 13163-7777 | |
| (315) 761-6770 | |
| Not Available |
| Full Name | Coppernoll Medical Practice Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Madison Ave, Wampsville, New York |
| Authorized Official Name and Position | Randolph L Snow (OWNER) |
| Authorized Official Contact | 3157616770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coppernoll Medical Practice Pllc 101 Madison Ave Wampsville NY 13163-7777 Ph: (315) 761-6770 | Coppernoll Medical Practice Pllc 101 Madison Ave Wampsville NY 13163-7777 Ph: (315) 761-6770 |
| NPI Number | 1750796173 |
|---|---|
| Provider Enumeration Date | 06/24/2014 |
| Last Update Date | 10/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750796173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
Muftah A. Kadura, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 235 Genesee St, Wampsville, NY 13163 Phone: 315-363-1363 Fax: 315-363-6889 |