| Family Medicine Of Mechanicville Pllc | |
|
242 S Central Ave Mechanicville NY 12118-3522 | |
| (518) 664-4185 | |
| (518) 539-2003 |
| Full Name | Family Medicine Of Mechanicville Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 242 S Central Ave, Mechanicville, New York |
| Authorized Official Name and Position | Ingrid Bermudez (OWNER) |
| Authorized Official Contact | 5186644185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Of Mechanicville Pllc 242 S Central Ave Mechanicville NY 12118-3522 Ph: (518) 664-4185 | Family Medicine Of Mechanicville Pllc 242 S Central Ave Mechanicville NY 12118-3522 Ph: (518) 664-4185 |
| NPI Number | 1487898425 |
|---|---|
| Provider Enumeration Date | 04/21/2009 |
| Last Update Date | 09/14/2009 |
| Medicare PECOS PAC ID | 4880749456 |
|---|---|
| Medicare Enrollment ID | O20090903000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487898425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 236934 (New York) | Primary |
| Provider Name | Ingrid Bermudez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295824134 PECOS PAC ID: 3476588948 Enrollment ID: I20051004000224 |
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