| Saratoga Family Medicine,pllc | |
|
100 Saratoga Village Blvd Suite 34 Malta NY 12020-3737 | |
| (518) 899-9090 | |
| (518) 899-9098 |
| Full Name | Saratoga Family Medicine,pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Saratoga Village Blvd, Malta, New York |
| Authorized Official Name and Position | Marianne A Mustafa (OWNER) |
| Authorized Official Contact | 5188999090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saratoga Family Medicine,pllc 100 Saratoga Village Blvd Suite 34 Malta NY 12020-3737 Ph: (518) 899-9090 | Saratoga Family Medicine,pllc 100 Saratoga Village Blvd Suite 34 Malta NY 12020-3737 Ph: (518) 899-9090 |
| NPI Number | 1386730752 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1153370515 |
|---|---|
| Medicare Enrollment ID | O20050113000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386730752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 226100 (New York) | Primary |
| Provider Name | Stephen C Fishel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992891378 PECOS PAC ID: 2769425461 Enrollment ID: I20050603000468 |
| Provider Name | Marianne A Mustafa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497841860 PECOS PAC ID: 8325097793 Enrollment ID: I20111121000637 |
| Provider Name | Jennifer B Tichich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124179130 PECOS PAC ID: 4587987904 Enrollment ID: I20141216000873 |
| Provider Name | Rosann Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285087320 PECOS PAC ID: 8820379399 Enrollment ID: I20170801000683 |
| Provider Name | Katie S Tafur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659891810 PECOS PAC ID: 9739452608 Enrollment ID: I20170829002917 |
| Provider Name | Amy M Yrsha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861048647 PECOS PAC ID: 5597197293 Enrollment ID: I20191119000974 |
| Provider Name | Kasey M Whelden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427836782 PECOS PAC ID: 2668828591 Enrollment ID: I20231027002412 |
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