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Organization
HUDSON MOHAWK PEDIATRICS
Active
Organization
HUDSON MOHAWK PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLE BUCKLEY (OWNER)
(518) 899-4133
Entity
Organization
Contact information
Practice address
318 RUHLE RD S, BALLSTON LAKE, NY 12019-1030
(518) 899-4133
Mailing address
318 RUHLE RD S, BALLSTON LAKE, NY 12019-1030
(518) 899-4133
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
107075
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00628079
—
NY
Enumeration date
07/09/2012
Last updated
07/09/2012
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