Organization
ADIRONDACK INTERVENTIONAL PHYSIATRY PC
Active
Other names
Champlain Spine & Pain Mgt
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THIERRY BONNABESSE MD (OWNER/PRESIDENT)
(518) 324-7246
Entity
Organization
Contact information
Practice address
4 FEATHERS DR, PLATTSBURGH, NY 12901-6461
(518) 324-7246
(518) 324-3366
Mailing address
4 FEATHERS DR, PLATTSBURGH, NY 12901-6461
(518) 324-7246
(518) 324-3366
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
231566
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00158767
RAILROAD MEDICARE
NY
Enumeration date
12/04/2006
Last updated
05/07/2021
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