| Maverick Family Medical, Pc | |
|
404 Zena Rd Woodstock NY 12498 | |
| (845) 679-5271 | |
| (845) 679-0726 |
| Full Name | Maverick Family Medical, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 404 Zena Rd, Woodstock, New York |
| Authorized Official Name and Position | Randall Sidney Rissman (PRESIDENT) |
| Authorized Official Contact | 8456795271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maverick Family Medical, Pc 404 Zena Rd Woodstock NY 12498 Ph: (845) 679-5271 | Maverick Family Medical, Pc 404 Zena Rd Woodstock NY 12498 Ph: (845) 679-5271 |
| NPI Number | 1891765244 |
|---|---|
| Provider Enumeration Date | 01/26/2006 |
| Last Update Date | 05/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891765244 | NPI | - | NPPES |
| 01907313 | Medicaid | NY | |
| 1213350001 | Other | NY | PTIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 142652 (New York) | Primary |
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Aeyoung Kim, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Park Dr, Woodstock, NY 12498 Phone: 845-679-8728 Fax: 845-679-1034 | |
One World Family Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2565 Route 212, Woodstock, NY 12498 Phone: 845-679-6210 Fax: 845-679-6214 | |
Arthur Dinapoli Md Phd Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Elwyn Ln, Woodstock, NY 12498 Phone: 845-679-7876 Fax: 845-679-3324 | |
Donn J. Wiedershine, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 62 Ricks Road, Woodstock, NY 12498 Phone: 848-208-1312 Fax: 845-679-2409 |