FAMILY MEDICINE OF MECHANICVILLE PLLC NPI 1487898425

NPI Information

NPI: 1487898425
Provider Name: FAMILY MEDICINE OF MECHANICVILLE PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 33D1098073

Address:
242 S CENTRAL AVE
MECHANICVILLE, NY
ZIP 12118
Phone: (518) 664-4185
Get Directions

FAMILY MEDICINE OF MECHANICVILLE PLLC is a primary care clinic center in Mechanicville, NY. FAMILY MEDICINE OF MECHANICVILLE PLLC NPI is 1487898425. The provider is registered as an organization entity type.

The provider's business location address is:

242 S CENTRAL AVE
MECHANICVILLE, NY
ZIP 12118-522
Phone: (518) 664-4185
Fax: (518) 539-2003

The provider's authorized official is Ingrid Bermudez .
The authorized official title is Owner and has the following contact phone number (518) 664-4185.

The CLIA number assigned to this NPI record is 33D1098073 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/21/2009 and was last updated on 9/14/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	236934	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I41835	MEDICARE UPIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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