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General NPI Number Information
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NPI Number | 1205192598
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Entity Type | Organization
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Legal Business Name | SARATOGA SCHENECTADY GASTROENTEROLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 1201 NOTT ST SUITE 207
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City | SCHENECTADY
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State | NY
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Zip | 12308-2589
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Country | US
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Telephone | 518-831-1500
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Fax | 518-377-1677
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Provider Business Mailing Address
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Address Line | PO BOX 569 848 ROUTE 50
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City | BURNT HILLS
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State | NY
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Zip | 12027-0569
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Country | US
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Telephone | 518-831-1500
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Fax | 518-377-1677
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MOLLIE MYERS
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Credential |
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Telephone | 518-831-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 154613
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License Number State | NY
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