Maverick Family Medical, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

142652 Issued in NY

Legal business name

MAVERICK FAMILY MEDICAL, PC

Doing business as

Maverick Family Health

Practice address

404 Zena Rd
Woodstock, NY 12498

Phone

(845) 679-5271

Fax

(845) 679-0726

NPI assigned

Jan 26, 2006

Last updated

May 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randall Sidney Rissman, M.D.NPI 1376645911

Title

President

Phone

(845) 679-5271

Specialties & licenses 1

Addresses

Other names 1

• MAVERICK FAMILY HEALTH Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randall Rissman, M.D.

  • Family Medicine Physician
  • Woodstock, NY
  • NPI 1376645911
  Authorized official Same address or phone

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1891765244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 ZENA RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "12498",
            "telephone_number": "845-679-5271",
            "fax_number": "845-679-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 ZENA RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "12498",
            "telephone_number": "845-679-5271",
            "fax_number": "845-679-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK FAMILY MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "RISSMAN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "SIDNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-679-5271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "142652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAVERICK FAMILY HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Hammel, PH.D., Psychologist, P.C.
• Mallory Markman
• Nancy Mastrocola, FNP
• Maverick Family Counseling
• Maverick Family Counseling LCSW PLLC (Maverick Family Counseling)
• Megan McCambley, MHC-LP
• James Jordan McErlean
• Medical Associates of the Hudson Valley
• Gil Nehemya Bloch Messer, LMSW
• Monica Ruth Meyer, MD

• Family Medicine Physician in Woodstock, NY
• Providers in Woodstock, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.