| William J Feeney MD PLLC | |
|
596 New Loudon Rd Latham NY 12110-4024 | |
| (518) 782-7133 | |
| Not Available |
| Full Name | William J Feeney MD PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 596 New Loudon Rd, Latham, New York |
| Authorized Official Name and Position | William J Feeney (OWNER) |
| Authorized Official Contact | 5187827133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William J Feeney MD PLLC Po Box 11719 Albany NY 12211-0719 Ph: (518) 389-1804 | William J Feeney MD PLLC 596 New Loudon Rd Latham NY 12110-4024 Ph: (518) 782-7133 |
| NPI Number | 1679565659 |
|---|---|
| Provider Enumeration Date | 08/17/2005 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Medicare PECOS PAC ID | 2163401134 |
|---|---|
| Medicare Enrollment ID | O20040714001435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679565659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 208000000X | Pediatrics | () | Secondary |
| Provider Name | William J Feeney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336146364 PECOS PAC ID: 8224017298 Enrollment ID: I20040714001502 |
| Provider Name | Kathleen M Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619977949 PECOS PAC ID: 4981893443 Enrollment ID: I20110113001166 |
| Provider Name | Korey Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902362627 PECOS PAC ID: 1557602406 Enrollment ID: I20190403001069 |
| Provider Name | Gina Ptak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992340749 PECOS PAC ID: 6103247267 Enrollment ID: I20200528002536 |
| Provider Name | Mary Yager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649954348 PECOS PAC ID: 0042667602 Enrollment ID: I20231103002414 |
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