Northeasttelemedicine

Organization Active NPI General Practice Physician · Diamond Point, NY

NPI 1942829759 · NPPES record last updated Apr 11, 2020

Key facts

NPI
1942829759
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
NORTHEASTTELEMEDICINE
Practice address
483 Coolidge Hill Rd
Diamond Point, NY 12824
Phone
(518) 260-1882
NPI assigned
Apr 11, 2020
Organization subpart
No

Authorized official

Name
Thomas Gavin, PA
Title
Physician Assistant
Phone
(518) 260-1882

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

483 Coolidge Hill Rd
Diamond Point, NY 12824

Mailing address

483 Coolidge Hill Rd
Diamond Point, NY 12824
Phone (518) 685-6032

Electronic endpoints

TypeEndpointUseAffiliation
RESTful URL gmail.com
RESTful URL gmail

Other providers in Diamond Point, NY

All providers in Diamond Point, NY · General Practice Physician in New York

Sources for this page

Verify at the official NPI Registry.