Organization
COMMUNITY CARE PHYSICIANS, PC
Active
Other names
The Office of Marino Baselice
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M STAMAS (SENIOR CREDENTIALING COORDINATOR)
(518) 782-3742
Entity
Organization
Contact information
Practice address
199 DELAWARE AVE, DELMAR, NY 12054-1229
(518) 439-1131
(518) 439-6306
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
134658
NY
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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