Bethel Medical Family Practice,PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BETHEL MEDICAL FAMILY PRACTICE,PC

Practice address

1522 State Route 17B
White Lake, NY 12786-5428

Phone

(845) 583-5620

Fax

(845) 583-8084

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Imran Ahmed, MD

Title

Owner

Phone

(845) 583-5620

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1982718607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 STATE ROUTE 17B",
            "address_2": "PO BOX 570",
            "city": "WHITE LAKE",
            "state": "NY",
            "postal_code": "127865428",
            "telephone_number": "845-583-5620",
            "fax_number": "845-583-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 STATE ROUTE 17B",
            "city": "WHITE LAKE",
            "state": "NY",
            "postal_code": "127865428",
            "telephone_number": "845-583-5620",
            "fax_number": "845-583-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL MEDICAL FAMILY PRACTICE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-583-5620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethel Volunteer Ambulance Corp Inc
• Rachel Michelle Cirino, LMSW
• Laurie A Devine, CCC-SLP
• Colleen Mary Dobbs, R.N.
• Dawn Houghtaling-Bryda

• Family Medicine Physician in White Lake, NY
• Providers in White Lake, 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 Dec 28, 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.