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General NPI Number Information
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NPI Number | 1255288452
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Entity Type | Organization
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Legal Business Name | MOHAWK VALLEY FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 1450 CHAMPLIN AVE
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City | UTICA
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State | NY
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Zip | 13502-3605
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Country | US
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Telephone | 315-624-2900
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Fax | 315-735-4391
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Provider Business Mailing Address
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Address Line | PO BOX 413
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City | NEW HARTFORD
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State | NY
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Zip | 13413-0413
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Country | US
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Telephone | 315-624-2900
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Fax | 315-735-4391
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Authorized Official
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Title or Position | OWNER
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Name | MARIO WASSEL
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Credential | MD
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Telephone | 315-624-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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