# COLUMBIA MEMORIAL REGIONAL MEDICAL PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Tannersville Family Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679166284
- **Authorized official:** BRYAN T. MAHONEY (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (518) 828-8090

## Contact information

- **Practice address:** 6171 ROUTE 23A, TANNERSVILLE, NY 12485
- **Practice address phone:** (518) 589-6843
- **Practice address fax:** (518) 589-6844
- **Mailing address:** PO BOX 2000, HUDSON, NY 12534-2000
- **Mailing address phone:** (518) 697-3258
- **Mailing address fax:** (518) 828-8183

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2021
- **Last updated:** 07/21/2021