Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 7 Bridge St, Phoenix, New York |
Authorized Official Name and Position | Karen Paterniti (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 3152986569 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
7 Bridge St Phoenix NY 13135-1906 Ph: (315) 695-4700 | 7 Bridge St Phoenix NY 13135-1906 Ph: (315) 695-4700 |
NPI Number | 1477953685 |
---|---|
Provider Enumeration Date | 08/26/2014 |
Last Update Date | 08/26/2014 |
Medicare PECOS PAC ID | 8426961541 |
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Medicare Enrollment ID | O20141211000186 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477953685 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |