Organization
COMMUNITY CARE PHYSICIANS, PC
Active
Other names
Latham Covid Vaccine Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBY COONS (CREDENTIALING MANAGER)
(518) 213-0478
Entity
Organization
Contact information
Practice address
713 TROY SCHENECTADY RD STE 224, LATHAM, NY 12110-2490
(518) 783-3110
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 783-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
01/21/2021
Last updated
07/29/2022
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