Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 166666 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 166666 | NY |
NPI | 1669451142 |
---|---|
Provider Name | Patricia A Ford |
First Address | Schenectady, NY 12305-1026 |
Second Address | Scotia, NY 12302-5219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 18/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060308000018 | FIDELIS CARE (01) | NY |
10051364 | CDPHP (01) | NY |
11537592 | CAQH (01) | |
4061644 | AETNA (01) | NY |
4147085 | MVP (01) | NY |
5617D1 | BLUE CROSS (01) | NY |
5617D2 | BLUE CROSS (01) | NY |
E28123 | (02) |