Luminescence Medical Pllc | |
1202 Troy Schenectady Road Building #2 Latham NY 12110 | |
(518) 389-6100 | |
Not Available |
Full Name | Luminescence Medical Pllc |
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Speciality | Family Medicine |
Location | 1202 Troy Schenectady Road, Latham, New York |
Authorized Official Name and Position | Prajesh Ghimire (PARTNER/PHYSICIAN) |
Authorized Official Contact | 5183302843 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Luminescence Medical Pllc 1202 Troy Schenectady Raod Building #2 Latham NY 12110 Ph: (518) 389-6100 | Luminescence Medical Pllc 1202 Troy Schenectady Road Building #2 Latham NY 12110 Ph: (518) 389-6100 |
NPI Number | 1760265540 |
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Provider Enumeration Date | 08/16/2023 |
Last Update Date | 08/16/2023 |
Medicare PECOS PAC ID | 0345786109 |
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Medicare Enrollment ID | O20240729002679 |
Identifier | Type | State | Issuer |
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1760265540 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
2083B0002X | Preventive Medicine - Obesity Medicine | (* (Not Available)) | Secondary |
Provider Name | Sean R Conner |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538328331 PECOS PAC ID: 8123211281 Enrollment ID: I20101021000214 |
Provider Name | Prajesh M Ghimire |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821300401 PECOS PAC ID: 5193987949 Enrollment ID: I20120503000072 |
Provider Name | Nabodita D Ghimire |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1720419831 PECOS PAC ID: 4789951146 Enrollment ID: I20170606002948 |
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