| |
785 Delaware Ave Delmar NY 12054-9713 | |
(518) 320-7517 | |
(518) 439-0214 |
Full Name | |
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Speciality | Family Medicine |
Location | 785 Delaware Ave, Delmar, New York |
Authorized Official Name and Position | Peter H Forman (OWNER) |
Authorized Official Contact | 5183207517 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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785 Delaware Ave Delmar NY 12054-9713 Ph: (518) 320-7517 | 785 Delaware Ave Delmar NY 12054-9713 Ph: (518) 320-7517 |
NPI Number | 1336356039 |
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Provider Enumeration Date | 05/16/2007 |
Last Update Date | 02/26/2008 |
Medicare PECOS PAC ID | 5092808816 |
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Medicare Enrollment ID | O20070910000499 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336356039 | NPI | - | NPPES |
02423509 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 228846-1 (New York) | Primary |
Provider Name | Peter H Forman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003905480 PECOS PAC ID: 9638262462 Enrollment ID: I20070910000525 |
Provider Name | Rebecca L Elliott |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194814574 PECOS PAC ID: 7810136348 Enrollment ID: I20130613000470 |
Provider Name | Antoinette M Gamon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538607775 PECOS PAC ID: 1850677576 Enrollment ID: I20170412001764 |
Provider Name | Amy S Banahan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265278758 PECOS PAC ID: 0749727782 Enrollment ID: I20240807003920 |
Andrew D. Coates, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Feura Bush Rd, Delmar, NY 12054 Phone: 518-429-8641 | |
Integrative Medical Associates Of New York, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 388 Kenwood Ave, Delmar, NY 12054 Phone: 518-689-2244 Fax: 518-689-2081 |