Organization
GREENVILLE MEDICAL ASSOCIATE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER W. HUBICKI II MD (PRESIDENT)
(518) 966-4433
Entity
Organization
Contact information
Practice address
77 COUNTY ROUTE 26A, GREENVILLE, NY 12083-3921
(518) 966-4433
(518) 966-4728
Mailing address
PO BOX 98, GREENVILLE, NY 12083-0098
(518) 966-4433
(518) 966-4728
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
227740
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000077419
GHI HMO
NY
05
—
02506687
—
NY
01
—
2339383
UNITEDHEALTHCARE
NY
01
—
239713
WELLCARE
NY
01
—
5996886
GHI PPO
NY
01
—
711974
MVP
NY
01
—
7828474
AETNA
NY
01
—
BSNENY
000404955001
NY
01
—
K262
CDPHP GROUP #
NY
Enumeration date
07/07/2006
Last updated
08/22/2020
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