| Pine Street Medical Pc | |
|
140 Pine St Kingston NY 12401-4948 | |
| (845) 338-0050 | |
| Not Available |
| Full Name | Pine Street Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 140 Pine St, Kingston, New York |
| Authorized Official Name and Position | George W. Mark Jobson (DIRECTOR) |
| Authorized Official Contact | 8453380050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Street Medical Pc 140 Pine St Kingston NY 12401-4948 Ph: (845) 338-0050 | Pine Street Medical Pc 140 Pine St Kingston NY 12401-4948 Ph: (845) 338-0050 |
| NPI Number | 1689667438 |
|---|---|
| Provider Enumeration Date | 08/26/2005 |
| Last Update Date | 07/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689667438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 166060 (New York) | Primary |
| 207R00000X | Internal Medicine | 166060 (New York) | Secondary |
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