Healthcare Provider Details

I. General information

NPI: 1669426680
Provider Name (Legal Business Name): HEDY MIGDEN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MADISON AVENUE EXT
ALBANY NY
12203-5396
US

IV. Provider business mailing address

24 MADISON AVENUE EXT
ALBANY NY
12203-5396
US

V. Phone/Fax

Practice location:
  • Phone: 518-452-5447
  • Fax: 518-452-5423
Mailing address:
  • Phone: 518-452-5447
  • Fax: 518-452-5423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number179056
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number179056
License Number StateNY

VIII. Authorized Official

Name: DR. HEDY MIGDEN
Title or Position: MD/OWNER
Credential: M.D.
Phone: 518-452-5447