MEDICARE: NEW CONCEPT MEDICAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	174341	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477697712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW CONCEPT MEDICAL CARE

Provider Business Mailing Address
First Line	:	9677 BREWERTON RD
Second Line	:
City	:	BREWERTON
State	:	NY
Zip	:	13029-8738
Country	:	US
Telephone Number	:	315-668-3908
Fax Number	:	315-668-3946

Provider Business Practice Location Address
First Line	:	9677 BREWERTON RD
Second Line	:
City	:	BREWERTON
State	:	NY
Zip	:	13029-8738
Country	:	US
Telephone Number	:	315-668-3908
Fax Number	:	315-668-3946

Authorized Official
Title or Position	:	OWNER
Name	:	LAURA E HAMILTON
Credential	:	M.D.
Telephone Number	:	315-668-3908

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	08/22/2020

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Directions to “NEW CONCEPT MEDICAL CARE ” Practice Location

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