Organization Active NPI

Newtonville Pediatrics & Internal Medicine

  • Health Service Clinic/Center
  • Latham, NY
National Provider Identifier
1821178682
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
195064 Issued in NY
Legal business name
NEWTONVILLE PEDIATRICS & INTERNAL MEDICINE
Practice address
564 New Loudon Rd
Latham, NY 12110-5336
Phone
(518) 783-1445
Fax
(518) 783-4622
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joanne Marie Fogarty, MD
Title
Owner
Phone
(518) 783-1445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 195064 NY Primary

Addresses

Primary practice location

564 New Loudon Rd
Latham, NY 12110-5336

Mailing address

564 New Loudon Rd
Latham, NY 12110-5336
Phone (518) 783-1445

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821178682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 NEW LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121105336",
            "telephone_number": "518-783-1445",
            "fax_number": "518-783-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 NEW LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121105336",
            "telephone_number": "518-783-1445",
            "fax_number": "518-783-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWTONVILLE PEDIATRICS & INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-783-1445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "195064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.