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Organization
HUDSON MOHAWK PEDIATRIC & ADOLESCENT MEDICINE
Active
Organization
HUDSON MOHAWK PEDIATRIC & ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLE B BUCKLEY M.D. (OWNER/PHYSICIAN)
(518) 899-4133
Entity
Organization
Contact information
Practice address
318 RUHLE RD S, BALLSTON LAKE, NY 12019-1030
(518) 899-4133
(518) 899-5764
Mailing address
318 RUHLE RD S, BALLSTON LAKE, NY 12019-1030
(518) 899-4133
(518) 899-5764
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
107075
NY
Other
Enumeration date
08/17/2006
Last updated
08/22/2020
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