Shaker Pediatrics Pc
Pediatric Adolescent Medicine
Shaker Pediatrics Pc is a Latham, New York based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
10 Century Hill Drive, Latham, New York - 12110. They can be contacted on phone at
518-783-5563 and fax number 518-785-5708.
NPI number (Unique professional ID) for Shaker Pediatrics Pc is
1336156223 which was assigned by NPPES on 02 Aug, 2006 and it was last updated on 22 Aug, 2020.
Shaker Pediatrics Pc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Shaker Pediatrics Pc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Shaker Pediatrics Pc |
|---|
Business Address:
Shaker Pediatrics Pc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 10 Century Hill Drive
Latham, NY, 12110
United States |
|---|
| Phone Number : | 518-783-5563 |
|---|
| Fax Number : | 518-785-5708 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1336156223 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 02 Aug, 2006 |
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| Last Updated On : | 22 Aug, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Henrym Neilley |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | FIRST VICE PRESIDENT |
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| Phone Number : | 518-783-5563 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Shaker Pediatrics Pc are as mentioned. Primary taxonomy code for Shaker Pediatrics Pc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Shaker Pediatrics Pc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 02094695 | MEDICAID | NY | |
| 349679 | Other | | MVP DAVID SHERWOOD MD |
| 000401569001 | Other | | BS HENRY NEILLEY MD |
| 1007 | Other | | CDPHP GROUP |
| 964787 | Other | | MVP SHEELA GRANEY MD |
| 000401387001 | Other | | BS WILLIAM A PETERSEN MD |
| 01332856 | MEDICAID | NY | |
| 10044836 | Other | | CDPHP DAVID SHERWOOD MD |
| 00392741 | MEDICAID | NY | |
| 000401340001 | Other | | BS SHEELA GRANEY MD |
| 01260746 | MEDICAID | NY | |
| 10001463 | Other | | CDPHP HENRY NEILLEY MD |
| 10002804 | Other | | CDPHP WM A PETERSEN MD |
| 10021167 | Other | | CDPHP SHEELA GRANEY MD |
| 26207 | Other | | MVP HENRY NEILLEY MD |
| 26208 | Other | | MVP WILLIAM A PETERSEN MD |
| 10002139 | Other | | CDPHP MARYLA WARSZAWA-AMB |
| 26210 | Other | | MVP MARYLA WARSZAWA-AMB |
| 00962767 | MEDICAID | NY | |
| 01762674 | MEDICAID | NY | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 10 Century Hill Drive
Latham, NY, 12110
United States |
|---|
| Phone Number : | 518-783-5563 |
|---|
| Fax Number : | 518-785-5708 |
|---|
Business Location:
Patients can refer following map for directions to
Shaker Pediatrics Pc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.