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General NPI Number Information
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NPI Number | 1548435266
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Entity Type | Organization
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Legal Business Name | BERKSHIRE FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 12594 STATE ROUTE 38
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City | BERKSHIRE
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State | NY
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Zip | 13736-1907
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Country | US
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Telephone | 607-657-8528
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Fax |
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Provider Business Mailing Address
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Address Line | 12594 STATE ROUTE 38
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City | BERKSHIRE
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State | NY
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Zip | 13736-1907
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Country | US
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Telephone | 607-657-8528
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. SHARLENE M KINNEY
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Credential | MD
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Telephone | 607-657-8528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 212187
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License Number State | NY
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