Clifton-fine Healthcare Corporation | |
1014 Oswegatchie Trail Rd Star Lake NY 13690-3143 | |
(315) 848-3351 | |
(315) 848-2314 |
Full Name | Clifton-fine Healthcare Corporation |
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Speciality | Clinic/Center |
Location | 1014 Oswegatchie Trail Rd, Star Lake, New York |
Authorized Official Name and Position | Dierdra Sorrell (CEO) |
Authorized Official Contact | 3158484260 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clifton-fine Healthcare Corporation 1014 Oswegatchie Trail Rd Star Lake NY 13690-3143 Ph: (315) 848-3351 | Clifton-fine Healthcare Corporation 1014 Oswegatchie Trail Rd Star Lake NY 13690-3143 Ph: (315) 848-3351 |
NPI Number | 1235184649 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 02/12/2025 |
Medicare PECOS PAC ID | 9739090382 |
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Medicare Enrollment ID | O20040511001168 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235184649 | NPI | - | NPPES |
02994847 | Medicaid | NY | |
330179 | Other | NY | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | James Stillerman |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1699881573 PECOS PAC ID: 3072572627 Enrollment ID: I20041008000137 |
Provider Name | Sarah A Delaney-rowland |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1871552844 PECOS PAC ID: 2062478357 Enrollment ID: I20041208000725 |
Provider Name | Lori A Lundberg |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1811995384 PECOS PAC ID: 0840393773 Enrollment ID: I20070314000523 |
Provider Name | David Paul Rechlin |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326090085 PECOS PAC ID: 8426015512 Enrollment ID: I20101028000383 |
Provider Name | Matthew D Zegil |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881656536 PECOS PAC ID: 2769493006 Enrollment ID: I20160609000987 |
Provider Name | Daniel Dennis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881044295 PECOS PAC ID: 4880598762 Enrollment ID: I20160916000341 |
Provider Name | David R Youngs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811422272 PECOS PAC ID: 5193096394 Enrollment ID: I20170807001844 |
Provider Name | Canh Tran |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1740674191 PECOS PAC ID: 3870849060 Enrollment ID: I20181129002978 |
Provider Name | Jessica E Barr |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760897250 PECOS PAC ID: 1355705369 Enrollment ID: I20230908003343 |
Provider Name | Michael Mccrory |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1558092460 PECOS PAC ID: 2961845334 Enrollment ID: I20240213002499 |
Provider Name | Rodesia Sharese Edmundson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124622667 PECOS PAC ID: 7214342179 Enrollment ID: I20241205002652 |