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Organization

UPSTATE PHYSICIAN SERVICES, PC

Active
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Organization

UPSTATE PHYSICIAN SERVICES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MUSTAFAIN Y MEGHANI MD (CEO)
(518) 687-1960
Entity
Organization

Contact information

Practice address
2001 5TH AVE, SUITE 110, TROY, NY 12180-3482
(518) 687-1960
(518) 687-1970
Mailing address
PO BOX 162, DELMAR, NY 12054-0162
(518) 687-1960
(518) 687-1970

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208M00000X
Hospitalist Physician
—
—
261Q00000X
Clinic/Center
171212063
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03925651
—
NY
05
—
04646599
—
NY
Enumeration date
01/22/2014
Last updated
03/17/2018
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