| Northeast Medical Practice Of New York Pc | |
|
69 State St Fl 13 Albany NY 12207-2512 | |
| (800) 931-5883 | |
| Not Available |
| Full Name | Northeast Medical Practice Of New York Pc |
|---|---|
| Speciality | General Practice |
| Location | 69 State St Fl 13, Albany, New York |
| Authorized Official Name and Position | Alex S Mohseni (PHYSICIAN OWNER) |
| Authorized Official Contact | 3017064461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Medical Practice Of New York Pc 1000 N West St Ste 12005035 Wilmington DE 19801-1050 Ph: (800) 931-5883 | Northeast Medical Practice Of New York Pc 69 State St Fl 13 Albany NY 12207-2512 Ph: (800) 931-5883 |
| NPI Number | 1841902186 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 03/25/2024 |
| Medicare PECOS PAC ID | 9436511946 |
|---|---|
| Medicare Enrollment ID | O20230816000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841902186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Betsy Larose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851648398 PECOS PAC ID: 7911239199 Enrollment ID: I20230703001838 |
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