| Lc Coelho Medical Pllc | |
|
325 Northern Blvd Albany NY 12204-1001 | |
| (518) 698-7544 | |
| Not Available |
| Full Name | Lc Coelho Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 325 Northern Blvd, Albany, New York |
| Authorized Official Name and Position | Luiz Coelho (OWNER) |
| Authorized Official Contact | 5186987544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lc Coelho Medical Pllc 72 High St Green Island NY 12183-1422 Ph: (518) 698-7544 | Lc Coelho Medical Pllc 325 Northern Blvd Albany NY 12204-1001 Ph: (518) 698-7544 |
| NPI Number | 1639512726 |
|---|---|
| Provider Enumeration Date | 04/09/2013 |
| Last Update Date | 04/09/2013 |
| Medicare PECOS PAC ID | 0941439798 |
|---|---|
| Medicare Enrollment ID | O20140128000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639512726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 246135 (New York) | Primary |
| Provider Name | Luiz C Coelho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164564514 PECOS PAC ID: 6800985466 Enrollment ID: I20071204000632 |
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