Upstate Medical Associates PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

181783 Issued in NY

Legal business name

UPSTATE MEDICAL ASSOCIATES PLLC

Practice address

446B Guy Park Ave.
Amsterdam, NY 12010-1005

Phone

(518) 843-0500

Fax

(518) 843-0600

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Krishnan Raghavan, M.D.

Title

President

Phone

(518) 843-0500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1891977559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446B GUY PARK AVE.",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-843-0500",
            "fax_number": "518-843-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446B GUY PARK AVE.",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101005",
            "telephone_number": "518-843-0500",
            "fax_number": "518-843-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "RAGHAVAN",
        "authorized_official_first_name": "KRISHNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-843-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "181783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tower Pharmacy Inc
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• Mary A. Tracy, PA-C
• Troy Optometric
• Blanche E. Turner, LPN
• Upstate Ny Doctor of Medicine PLLC
• Upstate Ny Physician PLLC
• Megan Vallee, OTR/L
• Johnathan Valovic
• Benjamine Van Heck, DPT

• Specialist in Amsterdam, NY
• Providers in Amsterdam, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.