Provider Demographics
NPI:1003844606
Name:NORTHEAST EMERGENCY MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:NORTHEAST EMERGENCY MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOCYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-383-5450
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:428 CLIFTON CORPORATE PARK
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-0807
Mailing Address - Country:US
Mailing Address - Phone:518-383-5450
Mailing Address - Fax:518-383-4223
Practice Address - Street 1:1101 NOTT ST
Practice Address - Street 2:@ ELLIS HOSPITAL ER DEPT.
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2425
Practice Address - Country:US
Practice Address - Phone:518-383-5450
Practice Address - Fax:518-383-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty