| Premise Health Of New York Medical, P.c | |
| 
					260 Hudson River Rd Waterford NY 12188-1910  | |
| (518) 233-2209 | |
| (518) 233-3747 | 
| Full Name | Premise Health Of New York Medical, P.c | 
|---|---|
| Speciality | Clinic/center - Multi-specialty | 
| Location | 260 Hudson River Rd, Waterford, New York | 
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) | 
| Authorized Official Contact | 6154686270 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Premise Health Of New York Medical, P.c 5500 Maryland Way Brentwood TN 37027-7048 Ph: () -  | Premise Health Of New York Medical, P.c 260 Hudson River Rd Waterford NY 12188-1910 Ph: (518) 233-2209  | 
| NPI Number | 1538991658 | 
|---|---|
| Provider Enumeration Date | 08/16/2024 | 
| Last Update Date | 08/16/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1538991658 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary | 
Mohammed Ismail Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 46 3rd St, Waterford, NY 12188 Phone: 518-237-0641 Fax: 518-235-6401  |