Edgard Quinones P.c. | |
122 E Main St Walden NY 12586-1554 | |
(845) 778-0423 | |
Not Available |
Full Name | Edgard Quinones P.c. |
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Speciality | Internal Medicine |
Location | 122 E Main St, Walden, New York |
Authorized Official Name and Position | Edgard Quinones (PRESIDENT) |
Authorized Official Contact | 8457780423 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Edgard Quinones P.c. 122 E Main St Walden NY 12586-1554 Ph: () - | Edgard Quinones P.c. 122 E Main St Walden NY 12586-1554 Ph: (845) 778-0423 |
NPI Number | 1861763096 |
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Provider Enumeration Date | 01/19/2012 |
Last Update Date | 01/19/2012 |
Medicare PECOS PAC ID | 6406023001 |
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Medicare Enrollment ID | O20120123000655 |
Identifier | Type | State | Issuer |
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1861763096 | NPI | - | NPPES |
00978501 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
Provider Name | Edgard Quinones |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1659444321 PECOS PAC ID: 2163332453 Enrollment ID: I20120124000093 |
Walden Medical, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 142 South Montgomery St, Walden, NY 12586 Phone: 845-778-5811 Fax: 845-778-5564 |