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General NPI Number Information
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NPI Number | 1356488613
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Entity Type | Organization
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Legal Business Name | SARATOGA GENERAL SURGERY, PLLC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 414 MAPLE AVE STE 700
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-5551
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Country | US
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Telephone | 518-587-1302
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Fax | 518-587-3818
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Provider Business Mailing Address
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Address Line | 414 MAPLE AVE STE 700
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-5551
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Country | US
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Telephone | 518-587-1302
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Fax | 518-587-3818
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Authorized Official
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Title or Position | OWNER
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Name | HOWARD L YEATON
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Credential | M.D., FACS
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Telephone | 518-587-1302
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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 | 188144
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License Number State | NY
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