# MYRTLE STREET OBSTETRICS AND GYNECOLOGY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629344320
- **Authorized official:** MS. LOUISE WEST (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (518) 587-5304

## Contact information

- **Practice address:** 2105 ELLSWORTH BLVD, MALTA, NY 12020
- **Practice address phone:** (518) 587-2400
- **Practice address fax:** (518) 581-0141
- **Mailing address:** 59 MYRTLE ST, SARATOGA SPRINGS, NY 12866-1093
- **Mailing address phone:** (518) 587-2400
- **Mailing address fax:** (518) 581-0141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 189300-1 | NY | Yes |

## Other

- **Enumeration date:** 03/27/2012
- **Last updated:** 03/27/2012