Sally M Hartwick, Md Pllc | |
25 Evergreen St Afton NY 13730-2129 | |
(607) 316-1576 | |
Not Available |
Full Name | Sally M Hartwick, Md Pllc |
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Speciality | Family Medicine |
Location | 25 Evergreen St, Afton, New York |
Authorized Official Name and Position | Sally Hartwick (OWNER) |
Authorized Official Contact | 6076392701 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sally M Hartwick, Md Pllc 25 Evergreen St Afton NY 13730-2129 Ph: (607) 639-2701 | Sally M Hartwick, Md Pllc 25 Evergreen St Afton NY 13730-2129 Ph: (607) 316-1576 |
NPI Number | 1205410784 |
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Provider Enumeration Date | 05/10/2021 |
Last Update Date | 12/03/2021 |
Medicare PECOS PAC ID | 1759786817 |
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Medicare Enrollment ID | O20210827000588 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205410784 | NPI | - | NPPES |
1275023020 | Other | TYPE 1 NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Sally Hartwick |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275023020 PECOS PAC ID: 2668877721 Enrollment ID: I20210827000660 |
Afton Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Evergreen Avenue, Afton, NY 13730 Phone: 607-639-2701 Fax: 607-639-3333 |