Organization
COLUMBIA MEMORIAL HOSPITAL
Active
Other names
Jefferson Heights Family Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN T MAHONEY (CFO)
(518) 828-8090
Entity
Organization
Contact information
Practice address
159 JEFFERSON HTS, SUITE D-201, CATSKILL, NY 12414
(518) 943-3415
(518) 943-0938
Mailing address
PO BOX 2000, HUDSON, NY 12534-2000
(518) 828-8051
(518) 697-3117
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
1001000H
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W79533
MEDICARE GROUP
NY
Enumeration date
07/26/2012
Last updated
07/12/2018
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