| Malta Family Medicine | |
|
100 Saratoga Village Blvd Ste 34 Ballston Spa NY 12020-3738 | |
| (518) 899-2632 | |
| (518) 899-6418 |
| Full Name | Malta Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Saratoga Village Blvd Ste 34, Ballston Spa, New York |
| Authorized Official Name and Position | Eugene K Merecki (OWNER) |
| Authorized Official Contact | 5188992632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malta Family Medicine 100 Saratoga Village Blvd Ste 34 Ballston Spa NY 12020-3738 Ph: (518) 899-2632 | Malta Family Medicine 100 Saratoga Village Blvd Ste 34 Ballston Spa NY 12020-3738 Ph: (518) 899-2632 |
| NPI Number | 1962527630 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 07/08/2010 |
| Medicare PECOS PAC ID | 4183789977 |
|---|---|
| Medicare Enrollment ID | O20090211000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962527630 | NPI | - | NPPES |
| AA1411 | Other | NY | NATIONAL GOVERNMENT SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 180894 (New York) | Primary |
| Provider Name | Eugene K Merecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720070808 PECOS PAC ID: 2264597053 Enrollment ID: I20090211000128 |
| Provider Name | Felicia A Heber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790123388 PECOS PAC ID: 0244472645 Enrollment ID: I20130814000979 |
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