Healthcare Provider Details

I. General information

NPI: 1366510091
Provider Name (Legal Business Name): ADIRONDACK PULMONARY & SLEEP MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 BOYNTON AVENUE SUITE A
PLATTSBURGH NY
12901
US

IV. Provider business mailing address

142 BOYNTON AVENUE SUITE A
PLATTSBURGH NY
12901
US

V. Phone/Fax

Practice location:
  • Phone: 518-562-9119
  • Fax: 518-562-0900
Mailing address:
  • Phone: 518-562-9119
  • Fax: 518-562-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number223963
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number042-0011093
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number223963
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number042-0011093
License Number StateVT

VIII. Authorized Official

Name: DR. SABIELI KABELI
Title or Position: SOLE OWNER
Credential: MD
Phone: 518-562-9119