| Hudson Headwaters Health Network | |
| 
					1019 Wicker St Ticonderoga NY 12883-1039  | |
| (518) 761-0300 | |
| (518) 824-2318 | 
| Full Name | Hudson Headwaters Health Network | 
|---|---|
| Speciality | Family Medicine | 
| Location | 1019 Wicker St, Ticonderoga, New York | 
| Authorized Official Name and Position | Christopher Tournier (CHIEF FINANCIAL OFFICER) | 
| Authorized Official Contact | 5187610300 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Hudson Headwaters Health Network 9 Carey Rd Queensbury NY 12804-7880 Ph: (518) 761-0300  | Hudson Headwaters Health Network 1019 Wicker St Ticonderoga NY 12883-1039 Ph: (518) 761-0300  | 
| NPI Number | 1972907749 | 
|---|---|
| Provider Enumeration Date | 10/22/2014 | 
| Last Update Date | 10/22/2014 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972907749 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
Hudson Headwaters Health Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1019 Wicker St, Ticonderoga, NY 12883 Phone: 518-745-5936  |