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63 Shaker Road Suite G02 Albany NY 12204 | |
(518) 449-5352 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 63 Shaker Road Suite G02, Albany, New York |
Authorized Official Name and Position | Courtney Knowles (CREDENTIALING MANAGER) |
Authorized Official Contact | 5185255634 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 14890 Albany NY 12212-4890 Ph: () - | 63 Shaker Road Suite G02 Albany NY 12204 Ph: (518) 449-5352 |
NPI Number | 1265086789 |
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Provider Enumeration Date | 08/01/2019 |
Last Update Date | 10/08/2021 |
Identifier | Type | State | Issuer |
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1265086789 | NPI | - | NPPES |
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 |