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100 Great Oaks Blvd Suite 105 Albany NY 12203 | |
(518) 869-8007 | |
(518) 869-8742 |
Full Name | |
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Speciality | Family Medicine |
Location | 100 Great Oaks Blvd, Albany, New York |
Authorized Official Name and Position | Debby Coons (CREDENTIALING MANAGER) |
Authorized Official Contact | 5182130478 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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711 Troy Schenectady Rd Ste 203 Latham NY 12110-2461 Ph: (518) 782-3700 | 100 Great Oaks Blvd Suite 105 Albany NY 12203 Ph: (518) 869-8007 |
NPI Number | 1942583554 |
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Provider Enumeration Date | 09/21/2011 |
Last Update Date | 05/31/2018 |
Identifier | Type | State | Issuer |
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1942583554 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Memorial Hospital, Albany, N.y. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 63 Shaker Rd Ste G02, Albany, NY 12204 Phone: 518-449-5352 |