Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Mar 24, 2021
License(s)
330732 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 624 MCCLELLAN ST | Schenectady, NY 12304-1020 | 518-347-5043 |
| MAILING | 624 MCCLELLAN ST | Schenectady, NY 12304-1020 | 518-347-5043 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.