NPIMap

Organization Active NPI

Northwestern Family Medical Ctr

  • Specialist
  • Ellenburg, NY
National Provider Identifier
1457572117
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
158672-1 Issued in NY
Legal business name
NORTHWESTERN FAMILY MEDICAL CTR
Practice address
16 St Edmunds Way
Ellenburg, NY 12933-9998
Phone
(518) 594-3500
Fax
(518) 594-3035
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa L Lapierre Millen, M.D.
Title
Collaborating Physician
Phone
(518) 594-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 158672-1 NY Primary

Addresses

Primary practice location

16 St Edmunds Way
Ellenburg, NY 12933-9998

Mailing address

16 St Edmunds Way
Ellenburg, NY 12933-9998
Phone (518) 594-3500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1457572117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ST EDMUNDS WAY",
            "city": "ELLENBURG",
            "state": "NY",
            "postal_code": "129339998",
            "telephone_number": "518-594-3500",
            "fax_number": "518-594-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ST EDMUNDS WAY",
            "city": "ELLENBURG",
            "state": "NY",
            "postal_code": "129339998",
            "telephone_number": "518-594-3500",
            "fax_number": "518-594-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN FAMILY MEDICAL CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "LAPIERRE MILLEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COLLABORATING PHYSICIAN",
        "authorized_official_telephone_number": "518-594-3500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "158672-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.