So, Juanito T

So, Juanito T is an individual health care provider with primary practice located at 380 Guy Park Ave St. Mary'S Hospital, Fam Hlth Cntr At Carondelet Pavili, Amsterdam NY 12010. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. So, Juanito T can be contacted via phone (518) 841-7415.

Contact Information

Primary practice address
380 Guy Park Ave St. Mary'S Hospital, Fam Hlth Cntr At Carondelet Pavili Amsterdam NY 12010
Phone: (518) 841-7415
Fax: (518) 841-7422
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 137258/-1 New York
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 137258-1 New York

Profile Details

NPI number 1659370146
LBN Legal business name So, Juanito T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Oct 24th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659370146 NPPES
New York Other 10010372 C.D.P.H.P.
New York MEDICAID 00462193 C.D.P.H.P.
New York Other 11506 C.D.P.H.P.

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