Healthcare Provider Details

I. General information

NPI: 1376596304
Provider Name (Legal Business Name): TWIN COUNTY MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 PROSPECT AVE SUITE 210
HUDSON NY
12534-2907
US

IV. Provider business mailing address

67 PROSPECT AVE SUITE 210
HUDSON NY
12534-2907
US

V. Phone/Fax

Practice location:
  • Phone: 518-828-2566
  • Fax: 518-828-4055
Mailing address:
  • Phone: 518-828-2566
  • Fax: 518-828-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: H LOUIS CLINTON
Title or Position: PRESIDENT
Credential: MD
Phone: 518-828-2566