Organization
COMMUNITY CARE PHYSICIANS, PC
Active
Other names
Community Care Pediatrics - Malta
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M STAMAS (SENIOR CREDENTIALING COORDINATOR)
(518) 782-3742
Entity
Organization
Contact information
Practice address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Mailing address
5 HEMPHILL PL, BUILDING 3, SUITE 123, MALTA, NY 12020-4422
(518) 584-0355
(518) 583-7665
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
206716
NY
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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