Individual
JAMES J VACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 EAST STATE STREET, MAB-GR01, GLOVERSVILLE, NY 12078
(518) 775-4201
(518) 775-4225
Mailing address
99 EAST STATE STREET, PO BOX 1250, GLOVERSVILLE, NY 12078
(518) 775-4201
(518) 775-4225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
138653
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000401141002
BSH NE NY
NY
05
—
00617152
—
NY
01
—
10026183
CDPHP
NY
01
—
950995
MVP HEALTHPLAN
NY
Enumeration date
07/28/2006
Last updated
01/22/2015
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