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47 Blaisdell Ave, Coeymans, NY 12045-7702 | |
(518) 334-9546 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Speech-language Pathologist |
Location | 47 Blaisdell Ave, Coeymans, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1841801529 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
Provider Name | Timothy Leonard Haller |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1285703041 PECOS PAC ID: 6406118447 Enrollment ID: I20180403000315 |
Mailing Address | Practice Location Address |
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Po Box 761, Coeymans, NY 12045-0761 Ph: (518) 334-9546 | 47 Blaisdell Ave, Coeymans, NY 12045-7702 Ph: (518) 334-9546 |
Mrs. Audry L June, MS CCC SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15 Uthe Blvd, Coeymans, NY 12045 Phone: 518-756-7285 |