| Mohawk Valley Nephrology Associates | |
|
555 French Rd Suite 103 New Hartford NY 13413-1044 | |
| (315) 735-3541 | |
| (315) 724-3255 |
| Full Name | Mohawk Valley Nephrology Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 555 French Rd, New Hartford, New York |
| Authorized Official Name and Position | Lorraine A Lane (BILLING MANAGER) |
| Authorized Official Contact | 3157243880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohawk Valley Nephrology Associates 555 French Rd Suite 103 New Hartford NY 13413-1044 Ph: (315) 735-3541 | Mohawk Valley Nephrology Associates 555 French Rd Suite 103 New Hartford NY 13413-1044 Ph: (315) 735-3541 |
| NPI Number | 1548287329 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 08/20/2009 |
| Medicare PECOS PAC ID | 8921074717 |
|---|---|
| Medicare Enrollment ID | O20040902001124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548287329 | NPI | - | NPPES |
| DC5232 | Other | NY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Charles J Eldredge |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215989322 PECOS PAC ID: 0143292128 Enrollment ID: I20040810001006 |
| Provider Name | Ahmad Mian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548346661 PECOS PAC ID: 6103824750 Enrollment ID: I20071105000409 |
| Provider Name | Daniel Freedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104596949 PECOS PAC ID: 5991102592 Enrollment ID: I20210924000440 |
| Provider Name | Dijana Ahmetasevic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265110506 PECOS PAC ID: 8022463207 Enrollment ID: I20231007000330 |
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