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NPI Code Detail

MEDICARE: CHARLENE HARRINGTON PA

MEDICARE:   CHARLENE  HARRINGTON  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant004799NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00175745OTHERNYRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356322564
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLENE HARRINGTON PA
Provider Business Mailing Address
First Line : PO BOX 304
Second Line :
City : GLENS FALLS
State : NY
Zip : 12801-0304
Country : US
Telephone Number : 518-747-1041
Fax Number : 518-747-1022
Provider Business Practice Location Address
First Line : 327 BROADWAY
Second Line : FORT EDWARD INTERNAL MEDICINE
City : FORT EDWARD
State : NY
Zip : 12828-1233
Country : US
Telephone Number : 518-747-1041
Fax Number : 518-747-1022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 06/07/2012

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Directions to “ CHARLENE HARRINGTON PA” Practice Location

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