Provider Demographics
NPI:1114043411
Name:ANDERSON MEDICAL P.C. DBA EMERGENCY ONE
Entity Type:Organization
Organization Name:ANDERSON MEDICAL P.C. DBA EMERGENCY ONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISIOR/SECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:COUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-338-5600
Mailing Address - Street 1:40 HURLEY AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3739
Mailing Address - Country:US
Mailing Address - Phone:845-338-5600
Mailing Address - Fax:845-338-3058
Practice Address - Street 1:40 HURLEY AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3739
Practice Address - Country:US
Practice Address - Phone:845-338-5600
Practice Address - Fax:845-338-3058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care