| Walden Medical, Pllc | |
|
142 South Montgomery St Walden NY 12586 | |
| (845) 778-5811 | |
| (845) 778-5564 |
| Full Name | Walden Medical, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 142 South Montgomery St, Walden, New York |
| Authorized Official Name and Position | Franklin P Guneratne (OWNER) |
| Authorized Official Contact | 8457785811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walden Medical, Pllc 142 South Montgomery St Walden NY 12586 Ph: (845) 778-5811 | Walden Medical, Pllc 142 South Montgomery St Walden NY 12586 Ph: (845) 778-5811 |
| NPI Number | 1568657005 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 09/07/2007 |
| Medicare PECOS PAC ID | 9133215015 |
|---|---|
| Medicare Enrollment ID | O20071024000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568657005 | NPI | - | NPPES |
| 00373744 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 117499 (New York) | Primary |
| 363A00000X | Physician Assistant | 007210 (New York) | Secondary |
| 363L00000X | Nurse Practitioner | 304569 (New York) | Secondary |
| Provider Name | Franklin Guneratne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649352048 PECOS PAC ID: 3870689755 Enrollment ID: I20071024000058 |
Edgard Quinones P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 122 E Main St, Walden, NY 12586 Phone: 845-778-0423 |