| Coxsackie Family Practice | |
|
24 Lafayette Ave Coxsackie NY 12051-1305 | |
| (518) 731-7777 | |
| Not Available |
| Full Name | Coxsackie Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 24 Lafayette Ave, Coxsackie, New York |
| Authorized Official Name and Position | Salvatore Licciardi (PHYSICIAN) |
| Authorized Official Contact | 5187317777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coxsackie Family Practice Po Box 215 Slingerlands NY 12159-0215 Ph: (518) 731-7777 | Coxsackie Family Practice 24 Lafayette Ave Coxsackie NY 12051-1305 Ph: (518) 731-7777 |
| NPI Number | 1114116845 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 11/28/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114116845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 169373 (New York) | Primary |
Columbia Memorial Regional Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Lafayette Ave, Coxsackie, NY 12051 Phone: 518-731-7770 |