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Contact Information

ADIRONDACK MEDICAL PRACTICE LLC
3384 RT 22
PERU, NY12972
 Phone: 518-643-8008
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ADIRONDACK MEDICAL PRACTICE LLC · (Female)

NPI Number 1518136001
Status Active
Credentials
Entity Individual
Enumeration date 02/28/2008
Last updated 02/28/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 006858-1
  • NY License # 009293-1
  • NY License # 162323-1
  • NY License # F331788
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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