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Organization
MYRTLE STREET OBSTETRICS AND GYNECOLOGY, PC
Active
Organization
MYRTLE STREET OBSTETRICS AND GYNECOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOUISE WEST (PRACTICE ADMINISTRATOR)
(518) 587-5304
Entity
Organization
Contact information
Practice address
2105 ELLSWORTH BLVD, MALTA, NY 12020
(518) 587-2400
(518) 581-0141
Mailing address
59 MYRTLE ST, SARATOGA SPRINGS, NY 12866-1093
(518) 587-2400
(518) 581-0141
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
189300-1
NY
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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