| North Country Adult Medicine Pllc | |
|
38 Hospital Dr Massena NY 13662-1018 | |
| (315) 764-1121 | |
| (315) 764-1972 |
| Full Name | North Country Adult Medicine Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 38 Hospital Dr, Massena, New York |
| Authorized Official Name and Position | Ellen M Thomson (BILLING SPECIALIST) |
| Authorized Official Contact | 3157641121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Country Adult Medicine Pllc 38 Hospital Dr Massena NY 13662-1018 Ph: (315) 764-1121 | North Country Adult Medicine Pllc 38 Hospital Dr Massena NY 13662-1018 Ph: (315) 764-1121 |
| NPI Number | 1710052451 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 11/04/2009 |
| Medicare PECOS PAC ID | 8325039878 |
|---|---|
| Medicare Enrollment ID | O20040521001271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710052451 | NPI | - | NPPES |
| 02883067 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (New York) | Primary |
| Provider Name | Neil J Cichetti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588679989 PECOS PAC ID: 0941291496 Enrollment ID: I20040521001299 |
| Provider Name | Joanne W Cichetti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578578977 PECOS PAC ID: 2769473214 Enrollment ID: I20040521001314 |
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