| Five Corners Family Practice | |
|
3040 Broadway Schenectady NY 12306-2102 | |
| (518) 357-2011 | |
| (518) 357-2330 |
| Full Name | Five Corners Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 3040 Broadway, Schenectady, New York |
| Authorized Official Name and Position | Patricia Merritt (PRESIDENT) |
| Authorized Official Contact | 5183572011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Five Corners Family Practice 3040 Broadway Schenectady NY 12306-2102 Ph: (518) 357-2011 | Five Corners Family Practice 3040 Broadway Schenectady NY 12306-2102 Ph: (518) 357-2011 |
| NPI Number | 1851353882 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 05/13/2021 |
| Medicare PECOS PAC ID | 3678513124 |
|---|---|
| Medicare Enrollment ID | O20050504000852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851353882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Patricia Merritt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457326399 PECOS PAC ID: 9739213786 Enrollment ID: I20100813000035 |
| Provider Name | Barbara J Lahey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477757219 PECOS PAC ID: 5890811350 Enrollment ID: I20100922000547 |
| Provider Name | Karen Dzingle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831757236 PECOS PAC ID: 4880008432 Enrollment ID: I20210122001673 |
| Provider Name | Ashley Lucht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285217893 PECOS PAC ID: 6406259399 Enrollment ID: I20210729003106 |
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