| |
71 Prospect Ave Suite L40 Hudson NY 12534-2907 | |
(518) 697-6000 | |
(518) 697-5345 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 71 Prospect Ave, Hudson, New York |
Authorized Official Name and Position | Shannon Ellsworth (OPERATIONS MANAGER) |
Authorized Official Contact | 5188288067 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2000 Hudson NY 12534-2000 Ph: (518) 828-8051 | 71 Prospect Ave Suite L40 Hudson NY 12534-2907 Ph: (518) 697-6000 |
NPI Number | 1053659284 |
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Provider Enumeration Date | 01/23/2013 |
Last Update Date | 04/18/2019 |
Identifier | Type | State | Issuer |
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1053659284 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 1001000H (New York) | Primary |
Prime Columbia Greene Medical Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 949 Columbia St, Hudson, NY 12534 Phone: 518-828-7188 Fax: 518-828-5049 |