| Oldendorf Medical Services, Pllc | |
|
407 Albany Shaker Rd Loudonville NY 12211-1900 | |
| (518) 435-1300 | |
| (518) 435-1397 |
| Full Name | Oldendorf Medical Services, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 407 Albany Shaker Rd, Loudonville, New York |
| Authorized Official Name and Position | Mark Oldendorf (MD/OWNER) |
| Authorized Official Contact | 5184351300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oldendorf Medical Services, Pllc 407 Albany Shaker Road Suite 100 Loudonville NY 12211-1902 Ph: (518) 435-1300 | Oldendorf Medical Services, Pllc 407 Albany Shaker Rd Loudonville NY 12211-1900 Ph: (518) 435-1300 |
| NPI Number | 1518107069 |
|---|---|
| Provider Enumeration Date | 02/24/2009 |
| Last Update Date | 08/08/2019 |
| Medicare PECOS PAC ID | 3274684949 |
|---|---|
| Medicare Enrollment ID | O20090622000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518107069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hedy L Migden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568422483 PECOS PAC ID: 3971595778 Enrollment ID: I20040401000521 |
| Provider Name | Mark W Oldendorf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427147800 PECOS PAC ID: 7113953142 Enrollment ID: I20050712000284 |
| Provider Name | Elaine M Serafini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760432314 PECOS PAC ID: 0648375915 Enrollment ID: I20070416000003 |
| Provider Name | Jonathan Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447244371 PECOS PAC ID: 9830289909 Enrollment ID: I20071213000580 |
| Provider Name | Corina L Gonzales |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770718793 PECOS PAC ID: 5395883771 Enrollment ID: I20140117000048 |
| Provider Name | Claudianus H Bourne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851646541 PECOS PAC ID: 7810111515 Enrollment ID: I20140620000114 |
| Provider Name | Jenna R Korim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427321140 PECOS PAC ID: 8123313707 Enrollment ID: I20160822000915 |
| Provider Name | Sudeep Jabaraj Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821203589 PECOS PAC ID: 5496818064 Enrollment ID: I20190425001709 |