Healthcare Provider Details

I. General information

NPI: 1639677404
Provider Name (Legal Business Name): SAXONY PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 WEMBLEY CT
ALBANY NY
12205
US

IV. Provider business mailing address

35 UNITED DR STE 102
WEST BRIDGEWATER MA
02379-1027
US

V. Phone/Fax

Practice location:
  • Phone: 518-704-4320
  • Fax: 518-389-6248
Mailing address:
  • Phone: 508-238-8646
  • Fax: 508-230-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC SIEGEL
Title or Position: OWNER
Credential: MD
Phone: 518-704-4320