Healthcare Provider Details

I. General information

NPI: 1174582373
Provider Name (Legal Business Name): HSS ANCILLARY MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 COLLEGE ST
HAMILTON NY
13346-1227
US

IV. Provider business mailing address

85 COLLEGE ST
HAMILTON NY
13346-1227
US

V. Phone/Fax

Practice location:
  • Phone: 315-824-1250
  • Fax: 315-824-8961
Mailing address:
  • Phone: 315-824-1250
  • Fax: 315-824-8961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA J BROWN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 315-824-1250