Northeasttelemedicine
General Practice in Diamond Point, NY. Organization (NPI-2).
NPI number1942829759
StatusActive
Last updated in NPPESApr 11, 2020
Details
- NPI
- 1942829759
- Entity type
- Organization (NPI-2)
- Legal business name
- Northeasttelemedicine
- Organization subpart
- No
- Enumeration date
- Apr 11, 2020
- Certification date
- Apr 11, 2020
- Last updated
- Apr 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
483 Coolidge Hill RdDiamond Point, NY 12824
Phone 518-260-1882
Mailing address
483 Coolidge Hill RdDiamond Point, NY 12824
Phone 518-685-6032
Authorized official
Thomas Gavin
Physician Assistant
5182601882
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