| Scotia Glenville Family Medicine, P.c. | |
| 
					112 Charlton Rd Ballston Lake NY 12019-2547  | |
| (518) 399-7723 | |
| (518) 399-6428 | 
| Full Name | Scotia Glenville Family Medicine, P.c. | 
|---|---|
| Speciality | Family Medicine | 
| Location | 112 Charlton Rd, Ballston Lake, New York | 
| Authorized Official Name and Position | Diane K Clarke (RN/NURSE MANAGER) | 
| Authorized Official Contact | 5183997723 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Scotia Glenville Family Medicine, P.c. 112 Charlton Rd Ballston Lake NY 12019-2547 Ph: (518) 399-7723  | Scotia Glenville Family Medicine, P.c. 112 Charlton Rd Ballston Lake NY 12019-2547 Ph: (518) 399-7723  | 
| NPI Number | 1619922218 | 
|---|---|
| Provider Enumeration Date | 05/23/2006 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1619922218 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 1678721 (New York) | Primary | 
Community Care Physicians, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1184 State Route 50, Ballston Lake, NY 12019 Phone: 518-384-1281 Fax: 518-384-0321  | |
Saratoga Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Charlton Rd, Cdphp Site, Ballston Lake, NY 12019 Phone: 518-399-7723 Fax: 518-399-6428  |