Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 30 Whittier Way, Ghent, New York |
Authorized Official Name and Position | Vinny Anand (CEO) |
Authorized Official Contact | 5188280717 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
30 Whittier Way Ghent NY 12075 Ph: (518) 828-0717 | 30 Whittier Way Ghent NY 12075 Ph: (518) 828-0717 |
NPI Number | 1467445601 |
---|---|
Provider Enumeration Date | 08/23/2005 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 7315854064 |
---|---|
Medicare Enrollment ID | O20020927000001 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467445601 | NPI | - | NPPES |
01687094 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 1059202R (New York) | Primary |
Your Family Doc, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 Sherman Potts Dr, Ghent, NY 12075 Phone: 518-314-0889 Fax: 518-244-8812 |