Medi Scene | |
585 Troy Schenectady Rd Latham NY 12110-2811 | |
(518) 785-6004 | |
(518) 785-1702 |
Full Name | Medi Scene |
---|---|
Speciality | General Practice |
Location | 585 Troy Schenectady Rd, Latham, New York |
Authorized Official Name and Position | Everett Roy Forman (PRESIDENT) |
Authorized Official Contact | 5188996657 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Medi Scene 47 Sweet Rd Ballston Lake NY 12019-1805 Ph: (518) 899-6657 | Medi Scene 585 Troy Schenectady Rd Latham NY 12110-2811 Ph: (518) 785-6004 |
NPI Number | 1144402983 |
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Provider Enumeration Date | 12/04/2007 |
Last Update Date | 12/19/2007 |
Medicare PECOS PAC ID | 1557451630 |
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Medicare Enrollment ID | O20071212000723 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144402983 | NPI | - | NPPES |
01148 | Other | NY | MVP |
000401336001 | Other | NY | BLUE SHJELD OF NENY |
080031557 | Other | NY | MEDICARE RAILROAD |
10000672 | Other | NY | CDPHP |
49E991 | Other | NY | EMPIRE BLUEXBLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Everett R Forman |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1528061967 PECOS PAC ID: 4486744562 Enrollment ID: I20071212000701 |
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