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Organization

CHAMPLAIN PAIN RELIEF AND NEUROLOGY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELLEN CELESTE GAUGHAN MD (OWNER)
(518) 566-8603
Entity
Organization

Contact information

Practice address
159 MARGARET STREET, SUITE 500, PLATTSBURGH, NY 12901
(518) 566-8603
(518) 566-8582
Mailing address
159 MARGARET STREET, SUITE 500, PLATTSBURGH, NY 12901
(518) 566-8603
(518) 566-8582

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
213308
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000495471003
BLUE SHIELD OF NENY
NY
05
01998998
NY
01
110639300
USDOL
NY
01
130023170
RRMCR
NY
01
2033749
AETNA
NY
01
698338
MVP
NY
01
8C1231
BLUE CROSS BLUE SHIELD
NY
01
P010213308
EXCELLUS BC BS
NY
Enumeration date
03/06/2007
Last updated
09/26/2011
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