National Provider Identifier Database

HUDSON MOHAWK PEDIATRICS
Children


Contact Information

HUDSON MOHAWK PEDIATRICS
318 RUHLE RD S
BALLSTON LAKE, NY12019-1030
Phone: 518-899-4133
Fax:
Website:
Specialty Taxonomy Code
* Children 282NC2000X

* Indicates primary specialty

NPI Profile & details for HUDSON MOHAWK PEDIATRICS

NPI Number 1225393986
Legal business name
LBN
HUDSON MOHAWK PEDIATRICS
Authorized official GAYLE BUCKLEY - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/09/2012
Last updated 07/09/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 107075
  • NY Medicaid: 00628079

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.

Reviews for HUDSON MOHAWK PEDIATRICS

There are currently no reviews for HUDSON MOHAWK PEDIATRICS


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