Full Name | |
---|---|
Speciality | Family Medicine |
Location | 501 Hurley Avenue, Hurley, New York |
Authorized Official Name and Position | Michael L Safran (OWNER) |
Authorized Official Contact | 8453394667 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
501 Hurley Avenue Hurley NY 12443 Ph: (845) 339-4667 | 501 Hurley Avenue Hurley NY 12443 Ph: (845) 339-4667 |
NPI Number | 1700954906 |
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Provider Enumeration Date | 12/04/2006 |
Last Update Date | 10/12/2018 |
Medicare PECOS PAC ID | 0648161513 |
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Medicare Enrollment ID | O20040322000549 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700954906 | NPI | - | NPPES |
5395 | Other | CDPHP | |
52284 | Other | MVP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Michael L Safran |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407994916 PECOS PAC ID: 2567441520 Enrollment ID: I20040714001390 |