| Hudson Shores Medical Group Pllc | |
|
1500 2nd Ave Watervliet NY 12189-2800 | |
| (518) 272-0028 | |
| Not Available |
| Full Name | Hudson Shores Medical Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1500 2nd Ave, Watervliet, New York |
| Authorized Official Name and Position | Ram Agrawal B (PRESIDENT) |
| Authorized Official Contact | 5182720028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hudson Shores Medical Group Pllc 1500 2nd Ave Watervliet NY 12189-2800 Ph: (518) 272-0028 | Hudson Shores Medical Group Pllc 1500 2nd Ave Watervliet NY 12189-2800 Ph: (518) 272-0028 |
| NPI Number | 1205934148 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 03/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205934148 | NPI | - | NPPES |
| 02177677 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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