Provider Demographics
NPI:1265720064
Name:EMURGENT CARE MEDICINE PLLC
Entity type:Organization
Organization Name:EMURGENT CARE MEDICINE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-731-9000
Mailing Address - Street 1:11835 RT 9W
Mailing Address - Street 2:
Mailing Address - City:WEST COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12192-3605
Mailing Address - Country:US
Mailing Address - Phone:518-731-9000
Mailing Address - Fax:518-731-9119
Practice Address - Street 1:2976 RT 9W
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-5234
Practice Address - Country:US
Practice Address - Phone:845-247-9100
Practice Address - Fax:518-731-9119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMURGENT CARE MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-13
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224556207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4937930001Medicare NSC
NYWEL751Medicare PIN