Provider Demographics
NPI:1265515217
Name:JOANNE H. VAN WOERT, MD, PC
Entity type:Organization
Organization Name:JOANNE H. VAN WOERT, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN WOERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-439-1564
Mailing Address - Street 1:1525 NEW SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9278
Mailing Address - Country:US
Mailing Address - Phone:518-439-1564
Mailing Address - Fax:
Practice Address - Street 1:1525 NEW SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9278
Practice Address - Country:US
Practice Address - Phone:518-439-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY564640Medicare ID - Type Unspecified