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NPI Code Detail

MEDICARE: ALEXANDER SAMUEL FORD DO

MEDICARE: ALEXANDER SAMUEL FORD DO
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
1207Q00000XFamily Medicine Physician323465-01NY
2133V00000XRegistered DietitianNY

General Provider Information

NPI Number : 1659900413
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER SAMUEL FORD DO
Provider Business Mailing Address
First Line : 711 TROY SCHENECTADY RD STE 203
Second Line :
City : LATHAM
State : NY
Zip : 12110-2461
Country : US
Telephone Number : 518-782-3700
Fax Number : 518-782-3799
Provider Business Practice Location Address
First Line : 1925 CURRY RD
Second Line :
City : SCHENECTADY
State : NY
Zip : 12303-3939
Country : US
Telephone Number : 518-356-5377
Fax Number : 518-881-1489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2020
Last Update Date : 06/13/2026

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