| |
4 Montgomery Hts Waddington NY 13694-7712 | |
(315) 388-7872 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 4 Montgomery Hts, Waddington, New York |
Authorized Official Name and Position | Rob Bloom (CFO) |
Authorized Official Contact | 3157135202 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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214 King St Ogdensburg NY 13669-1142 Ph: (315) 393-3600 | 4 Montgomery Hts Waddington NY 13694-7712 Ph: (315) 388-7872 |
NPI Number | 1922614973 |
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Provider Enumeration Date | 09/16/2020 |
Last Update Date | 01/26/2022 |
Identifier | Type | State | Issuer |
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1922614973 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |