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General NPI Number Information
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NPI Number | 1003858580
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Entity Type | Organization
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Legal Business Name | ADIRONDACK SURGICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 PARK ST SUITE 202
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City | GLENS FALLS
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State | NY
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Zip | 12801-4449
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Country | US
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Telephone | 518-761-2347
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Fax | 518-793-6658
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Provider Business Mailing Address
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Address Line | PO BOX 787 SUITE 202
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City | GLENS FALLS
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State | NY
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Zip | 12801-0787
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Country | US
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Telephone | 518-761-2347
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Fax | 518-793-6658
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DENIS LUSIGNAN
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Credential | M.D.
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Telephone | 518-761-2347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 104380
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License Number State | NY
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