| Cmh-lafayette Family Care | |
|
24 Lafayette Ave Coxsackie NY 12051-1305 | |
| (518) 731-7770 | |
| Not Available |
| Full Name | Cmh-lafayette Family Care |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 24 Lafayette Ave, Coxsackie, New York |
| Authorized Official Name and Position | Bryan T. Mahoney (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5188288090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmh-lafayette Family Care Po Box 2000 Hudson NY 12534-2000 Ph: (518) 828-8051 | Cmh-lafayette Family Care 24 Lafayette Ave Coxsackie NY 12051-1305 Ph: (518) 731-7770 |
| NPI Number | 1417540824 |
|---|---|
| Provider Enumeration Date | 02/17/2021 |
| Last Update Date | 07/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417540824 | NPI | - | NPPES |
| 03227290 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Coxsackie Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Lafayette Ave, Coxsackie, NY 12051 Phone: 518-731-7777 |