Provider Demographics
NPI:1689713067
Name:WOMEN'S CANCER CARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WOMEN'S CANCER CARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-458-1390
Mailing Address - Street 1:319 S MANNING BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1742
Mailing Address - Country:US
Mailing Address - Phone:518-281-6486
Mailing Address - Fax:
Practice Address - Street 1:319 S MANNING BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1742
Practice Address - Country:US
Practice Address - Phone:518-281-6486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19357612086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56917KMedicare ID - Type UnspecifiedKREDENTSER MEDICARE NUMBE