Provider Demographics
NPI:1689223919
Name:ADIRONDACK OSTEOPATHY PLLC
Entity Type:Organization
Organization Name:ADIRONDACK OSTEOPATHY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WALDORF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:518-526-9996
Mailing Address - Street 1:17 MILLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12928-2539
Mailing Address - Country:US
Mailing Address - Phone:518-526-9996
Mailing Address - Fax:518-240-4172
Practice Address - Street 1:17 MILLER DRIVE
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:NY
Practice Address - Zip Code:12928-2539
Practice Address - Country:US
Practice Address - Phone:518-526-9996
Practice Address - Fax:518-240-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty