HUDSON MOHAWK PEDIATRIC & ADOLESCENT MEDICINE
NPI 1306950563
Specialist in Ballston Lake, NY
- Organization
- Specialist
About HUDSON MOHAWK PEDIATRIC & ADOLESCENT MEDICINE
This page provides the complete NPI Profile along with additional information for Hudson Mohawk Pediatric & Adolescent Medicine, a provider established in Ballston Lake, New York operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1306950563 assigned on August 2006. The practitioner's primary taxonomy code is 174400000X with license number 107075 (NY). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Gayle B Buckley M.d. (Owner/physician)
- NPI
- 1306950563 Verify this NPI
- Provider Name
- HUDSON MOHAWK PEDIATRIC & ADOLESCENT MEDICINE
- Entity Type
- Organization
- Location Address
- 318 RUHLE RD S BALLSTON LAKE, NY 12019
- Location Phone
- (518) 899-4133
- Location Fax
- (518) 899-5764
- Mailing Address
- 318 RUHLE RD S BALLSTON LAKE, NY 12019
- Mailing Phone
- (518) 899-4133
- Mailing Fax
- (518) 899-5764
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-17-2006
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 107075
- License State
- NY
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
BALLSTON LAKE, NY 12019
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306950563, enumerated as an "organization" on August 17, 2006.
The provider is located at 318 RUHLE RD S BALLSTON LAKE, NY 12019 and the phone number is (518) 899-4133.
Specialist with taxonomy code 174400000X.
