Provider Demographics
NPI:1609813971
Name:EAST HILL FAMILY MEDICAL, INC.
Entity Type:Organization
Organization Name:EAST HILL FAMILY MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-253-8477
Mailing Address - Street 1:144 GENESEE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3503
Mailing Address - Country:US
Mailing Address - Phone:315-253-6796
Mailing Address - Fax:315-252-6354
Practice Address - Street 1:144 GENESEE ST
Practice Address - Street 2:SUITE 401 AND SUITE 201
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3503
Practice Address - Country:US
Practice Address - Phone:315-253-7364
Practice Address - Fax:315-253-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356161Medicaid
NY=========OtherBLUE SHIELD
NY00356161Medicaid
NY=========OtherBLUE SHIELD