Organization
COMMUNITY CARE PHYSICIANS, PLLC
Active
Parent organization
COMMUNITY CARE PHYSICIANS, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CARE PHYSICIANS, PLLC
Authorized official
DIANE MARIE STAMAS (CREDENTIALING COORDINATOR)
(518) 782-3742
Entity
Organization
Contact information
Practice address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207U00000X
Nuclear Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00863552
—
NY
Enumeration date
06/07/2006
Last updated
03/27/2024
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