Organization
ADIRONDACK MEDICAL CENTER
Active
Other names
Adirondack Medical Center Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN S STRATFORD CPC (PFS SUPERVISOR)
(518) 897-2636
Entity
Organization
Contact information
Practice address
114 WAWBEEK AVE, TUPPER LAKE, NY 12986-2038
(518) 359-4900
(518) 891-5097
Mailing address
114 WAWBEEK AVE, TUPPER LAKE, NY 12986-2038
(518) 359-4900
(518) 891-5097
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
1623001H
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-3564
MEDICARE CCN
NY
Enumeration date
08/18/2010
Last updated
10/16/2014
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