Individual
DR. ELIZABETH ANNE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
713 TROY SCHENECTADY RD, SUITE 224, LATHAM, NY 12110-2490
(518) 785-5881
(518) 785-3872
Mailing address
711 TROY SCHENECTADY RD, SUITE 201, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2527791
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03130169
—
NY
01
—
P00746889
RR MEDICARE
NY
Enumeration date
08/13/2008
Last updated
01/25/2010
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