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4624 Salina St Pulaski NY 13142-2102 | |
(315) 298-2696 | |
(315) 298-7831 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4624 Salina St, Pulaski, New York |
Authorized Official Name and Position | Karen Paterniti (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 3152986569 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4624 Salina St Pulaski NY 13142-2102 Ph: (315) 298-2696 | 4624 Salina St Pulaski NY 13142-2102 Ph: (315) 298-2696 |
NPI Number | 1669873071 |
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Provider Enumeration Date | 09/05/2014 |
Last Update Date | 09/05/2014 |
Medicare PECOS PAC ID | 8426961541 |
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Medicare Enrollment ID | O20150310000237 |
Identifier | Type | State | Issuer |
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1669873071 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
Jay F Sullivan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4882b North Jefferson St, Pulaski, NY 13142 Phone: 315-298-2768 | |