Provider Demographics
NPI:1083773022
Name:EMERGENCY MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:EMERGENCY MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOCYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-383-5450
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-0429
Mailing Address - Country:US
Mailing Address - Phone:518-383-5450
Mailing Address - Fax:518-383-4223
Practice Address - Street 1:1101 NOTT ST
Practice Address - Street 2:ELLIS HOSPITAL ER DEPT.
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2425
Practice Address - Country:US
Practice Address - Phone:518-243-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02823090Medicaid