Provider Demographics
NPI:1780658658
Name:HORNICK, DAVID N (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:HORNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1737 UNION ST
Mailing Address - Street 2:PMB 741M
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6242
Mailing Address - Country:US
Mailing Address - Phone:518-346-3100
Mailing Address - Fax:518-688-1342
Practice Address - Street 1:16 CRIMSON OAK CT
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-2234
Practice Address - Country:US
Practice Address - Phone:518-346-3100
Practice Address - Fax:518-688-1342
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2012-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY146125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01624139Medicaid
NY01624139Medicaid
NYG20200Medicare UPIN