Provider Demographics
NPI:1932293651
Name:MAYER AND COPE FAMILY PRACTICE LLP
Entity Type:Organization
Organization Name:MAYER AND COPE FAMILY PRACTICE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-883-3121
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:BROADALBIN
Mailing Address - State:NY
Mailing Address - Zip Code:12025
Mailing Address - Country:US
Mailing Address - Phone:518-883-3121
Mailing Address - Fax:
Practice Address - Street 1:3768 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:BROADALBIN
Practice Address - State:NY
Practice Address - Zip Code:12025
Practice Address - Country:US
Practice Address - Phone:518-883-3121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY40016AMedicare ID - Type Unspecified