Individual
AMY ELIZABETH HOGAN-MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 BROAD STREET PLZ, BROAD STREET MEDICAL GROUP, GLENS FALLS, NY 12801-4363
(518) 926-1770
(518) 926-1799
Mailing address
PO BOX 304, GLENS FALLS, NY 12801-0304
(518) 926-1770
(518) 926-1799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
210381
NY
207RN0300X
Nephrology Physician
Primary
210381
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01824359
—
NY
01
—
390006064
RR MEDICARE
NY
Enumeration date
10/12/2005
Last updated
06/05/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us