| Mohammed Ismail Md Pc | |
|
46 3rd St Waterford NY 12188 | |
| (518) 237-0641 | |
| (518) 235-6401 |
| Full Name | Mohammed Ismail Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 46 3rd St, Waterford, New York |
| Authorized Official Name and Position | Mohammed Ismail (OWNER) |
| Authorized Official Contact | 5182370641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammed Ismail Md Pc 46 3rd St Waterford NY 12188 Ph: (518) 237-0641 | Mohammed Ismail Md Pc 46 3rd St Waterford NY 12188 Ph: (518) 237-0641 |
| NPI Number | 1306935895 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/23/2011 |
| Medicare PECOS PAC ID | 6608906888 |
|---|---|
| Medicare Enrollment ID | O20100615000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306935895 | NPI | - | NPPES |
| 02217870 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 227997 (New York) | Primary |
| Provider Name | Mohammed Ismail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477588747 PECOS PAC ID: 9032249222 Enrollment ID: I20100615000343 |
Premise Health Of New York Medical, P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 Hudson River Rd, Waterford, NY 12188 Phone: 518-233-2209 Fax: 518-233-3747 | |
Waterford Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 158 Saratoga Ave, Waterford, NY 12188 Phone: 518-233-1162 Fax: 518-233-0903 |