Your Family Doc, P.c. | |
2 Sherman Potts Dr Ghent NY 12075-3216 | |
(518) 314-0889 | |
(518) 244-8812 |
Full Name | Your Family Doc, P.c. |
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Speciality | Family Medicine |
Location | 2 Sherman Potts Dr, Ghent, New York |
Authorized Official Name and Position | Vahe Avedis Keukjian (PRESIDENT) |
Authorized Official Contact | 5183140889 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Your Family Doc, P.c. 2 Sherman Potts Dr Ghent NY 12075-3216 Ph: (518) 314-0889 | Your Family Doc, P.c. 2 Sherman Potts Dr Ghent NY 12075-3216 Ph: (518) 314-0889 |
NPI Number | 1053672238 |
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Provider Enumeration Date | 06/04/2012 |
Last Update Date | 07/11/2012 |
Medicare PECOS PAC ID | 3779748272 |
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Medicare Enrollment ID | O20120709000252 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053672238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Lance M Castellana |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780638676 PECOS PAC ID: 6103975123 Enrollment ID: I20090522000117 |
Dba Columbia-greene Dialysis Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Whittier Way, Ghent, NY 12075 Phone: 518-828-0717 Fax: 517-822-0776 |