| Edgard Quinones P.c. | |
|
122 E Main St Walden NY 12586-1554 | |
| (845) 778-0423 | |
| Not Available |
| Full Name | Edgard Quinones P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 122 E Main St, Walden, New York |
| Authorized Official Name and Position | Edgard Quinones (PRESIDENT) |
| Authorized Official Contact | 8457780423 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgard Quinones P.c. 122 E Main St Walden NY 12586-1554 Ph: () - | Edgard Quinones P.c. 122 E Main St Walden NY 12586-1554 Ph: (845) 778-0423 |
| NPI Number | 1861763096 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 01/19/2012 |
| Medicare PECOS PAC ID | 6406023001 |
|---|---|
| Medicare Enrollment ID | O20120123000655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861763096 | NPI | - | NPPES |
| 00978501 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
| Provider Name | Edgard Quinones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659444321 PECOS PAC ID: 2163332453 Enrollment ID: I20120124000093 |
Walden Medical, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 142 South Montgomery St, Walden, NY 12586 Phone: 845-778-5811 Fax: 845-778-5564 |