Individual
DR. ANITA K BUROCK STOTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 ANTHONY WAY, SCHENECTADY, NY 12303-3512
(518) 355-2060
Mailing address
PO BOX 268, GUILDERLAND, NY 12084-0268
(518) 355-2060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
165459
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093422
GHI-HMO
NY
01
—
000411069004
BLUE SHIELD
NY
01
—
040426006836
FIDELIS
NY
01
—
10000243
CDPHP
NY
01
—
108AR1
BLUE CROSS
NY
01
—
11268278
CAQH
NY
01
—
165459-9W
WORKERS COMP
NY
01
—
391448
MVP
NY
01
—
5895325
AETNA
NY
01
—
9720880
GHI-PPO
NY
01
—
DB1987
RAILROAD MEDICARE
NY
Enumeration date
04/27/2006
Last updated
07/07/2010
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