MEDICARE: SARATOGA CARE FAMILY HEALTH CENTERS, INC.

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

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	:	1619962404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARATOGA CARE FAMILY HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	201 CHURCH ST
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-1009
Country	:	US
Telephone Number	:	518-580-2022
Fax Number	:	518-584-0466

Provider Business Practice Location Address
First Line	:	119 LAWRENCE ST
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-1346
Country	:	US
Telephone Number	:	518-584-7361
Fax Number	:	518-584-7930

Authorized Official
Title or Position	:	BUSINESS OFFICE COORDINATOR
Name	:	TERRY ROSS
Credential	:
Telephone Number	:	518-580-2022

Provider Enumeration Date	:	09/17/2005
Last Update Date	:	01/11/2008

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