Provider Demographics
NPI:1760171680
Name:NORTH COUNTRY EC LLC
Entity Type:Organization
Organization Name:NORTH COUNTRY EC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCEUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-450-1304
Mailing Address - Street 1:135 NORTH RD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1308
Mailing Address - Country:US
Mailing Address - Phone:518-450-1304
Mailing Address - Fax:
Practice Address - Street 1:135 NORTH RD BLDG 2
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:NY
Practice Address - Zip Code:12831-1308
Practice Address - Country:US
Practice Address - Phone:518-450-1304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH COUNTRY EC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty