Healthcare Provider Details

I. General information

NPI: 1083773022
Provider Name (Legal Business Name): EMERGENCY MEDICAL ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 NOTT ST ELLIS HOSPITAL ER DEPT.
SCHENECTADY NY
12308-2425
US

IV. Provider business mailing address

PO BOX 429
CLIFTON PARK NY
12065-0429
US

V. Phone/Fax

Practice location:
  • Phone: 518-243-4121
  • Fax:
Mailing address:
  • Phone: 518-383-5450
  • Fax: 518-383-4223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STANLEY W DOCYK
Title or Position: PRESIDENT
Credential: MD
Phone: 518-383-5450