Organization
NORTHWAY SPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASANDRA A. HOPKINS RN, MSN (ADMINISTRATOR)
(518) 371-6772
Entity
Organization
Contact information
Practice address
1596 ROUTE 9, HALFMOON, NY 12065
(518) 322-7720
Mailing address
1596 ROUTE 9, HALFMOON, NY 12065-4303
(518) 371-6772
(518) 288-2835
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
4552201R
NY
Other
Enumeration date
06/16/2015
Last updated
04/07/2016
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