| Your Family Doc, P.c. | |
|
2 Sherman Potts Dr Ghent NY 12075-3216 | |
| (518) 314-0889 | |
| (518) 244-8812 |
| Full Name | Your Family Doc, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2 Sherman Potts Dr, Ghent, New York |
| Authorized Official Name and Position | Vahe Avedis Keukjian (PRESIDENT) |
| Authorized Official Contact | 5183140889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Family Doc, P.c. 2 Sherman Potts Dr Ghent NY 12075-3216 Ph: (518) 314-0889 | Your Family Doc, P.c. 2 Sherman Potts Dr Ghent NY 12075-3216 Ph: (518) 314-0889 |
| NPI Number | 1053672238 |
|---|---|
| Provider Enumeration Date | 06/04/2012 |
| Last Update Date | 07/11/2012 |
| Medicare PECOS PAC ID | 3779748272 |
|---|---|
| Medicare Enrollment ID | O20120709000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053672238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lance M Castellana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780638676 PECOS PAC ID: 6103975123 Enrollment ID: I20090522000117 |
Green Manor Dialysis Center Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 30 Whittier Way, Ghent, NY 12075 Phone: 518-828-0717 Fax: 517-822-0776 |