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1444 Western Ave Suite A Albany NY 12203-3440 | |
(518) 489-2812 | |
(518) 489-2444 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1444 Western Ave, Albany, New York |
Authorized Official Name and Position | Michael Whalen (DIRECTOR OF ADMINISTRATION) |
Authorized Official Contact | 5184352704 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4 Atrium Dr Suite 100 Albany NY 12205-1441 Ph: (518) 435-2704 | 1444 Western Ave Suite A Albany NY 12203-3440 Ph: (518) 489-2812 |
NPI Number | 1639399645 |
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Provider Enumeration Date | 05/01/2007 |
Last Update Date | 03/28/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639399645 | NPI | - | NPPES |
02616571 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 54964 (New York) | Primary |
Memorial Hospital, Albany, N.y. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 63 Shaker Rd Ste G02, Albany, NY 12204 Phone: 518-449-5352 |