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Organization
UPSTATE PHYSICIAN SERVICES, PC
Active
Organization
UPSTATE PHYSICIAN SERVICES, PC
Active
Other names
New Haven Addiction Services OP
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAFAIN MEGHANI MD (OWNER)
(518) 687-1960
Entity
Organization
Contact information
Practice address
2001 5TH AVENUE, SUITE 110, TROY, NY 12180
(518) 687-1960
(518) 687-1970
Mailing address
2001 5TH AVENUE, TROY, NY 12180
(518) 687-1960
(518) 687-1970
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
171212063
NY
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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