Provider Demographics
NPI:1669426680
Name:HEDY MIGDEN MD PC
Entity type:Organization
Organization Name:HEDY MIGDEN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-452-5447
Mailing Address - Street 1:24 MADISON AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5396
Mailing Address - Country:US
Mailing Address - Phone:518-452-5447
Mailing Address - Fax:518-452-5423
Practice Address - Street 1:24 MADISON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5396
Practice Address - Country:US
Practice Address - Phone:518-452-5447
Practice Address - Fax:518-452-5423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179056208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0490Medicare UPIN