| Modena Pcp | |
|
2044 Route 32 Suite4 Modena NY 12548 | |
| (845) 883-5176 | |
| (845) 883-5177 |
| Full Name | Modena Pcp |
|---|---|
| Speciality | Family Medicine |
| Location | 2044 Route 32, Modena, New York |
| Authorized Official Name and Position | Ronald Tatelbaum (PRESIDENT) |
| Authorized Official Contact | 8454759635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modena Pcp 1351 Route 55 Suite 200 Lagrangeville NY 12540-5108 Ph: (845) 475-9661 | Modena Pcp 2044 Route 32 Suite4 Modena NY 12548 Ph: (845) 883-5176 |
| NPI Number | 1992190722 |
|---|---|
| Provider Enumeration Date | 03/30/2015 |
| Last Update Date | 03/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992190722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
Modena Family Practice, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2044 Route 32, Suite 4, Modena, NY 12548 Phone: 845-883-5176 Fax: 845-883-5177 |