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Organization
PRIME COLUMBIA GREENE MEDICAL ASSOCIATES, PC
Active
Organization
PRIME COLUMBIA GREENE MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARENCE B HENRY MD (PRESIDENT)
(518) 828-7188
Entity
Organization
Contact information
Practice address
949 COLUMBIA ST, HUDSON, NY 12534-2624
(518) 828-7188
(518) 828-5049
Mailing address
949 COLUMBIA ST, HUDSON, NY 12534-2624
(518) 828-7188
(518) 828-5049
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
209006
NY
207RG0100X
Gastroenterology Physician
109985
NY
208100000X
Physical Medicine & Rehabilitation Physician
123180
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00195813
—
NY
05
—
02311659
—
NY
Enumeration date
04/24/2006
Last updated
11/04/2011
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