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General NPI Number Information
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NPI Number | 1912408477
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Entity Type | Organization
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Legal Business Name | MEDICINE HORSE FARM CORP
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 38 LIZZIES LANE
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City | MORRISONVILLE
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State | NY
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Zip | 12962
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Country | US
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Telephone | 518-566-7217
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Fax |
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Provider Business Mailing Address
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Address Line | 38 LIZZIES LANE
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City | MORRISONVILLE
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State | NY
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Zip | 12962
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Country | US
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Telephone | 518-566-7217
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Fax |
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Authorized Official
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Title or Position | CEO/ INSTRUCTOR
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Name | MARIE ANN POSTIGLIONE-DUPELL
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Credential |
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Telephone | 518-566-7217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State | NY
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