Koinonia Primary Care And Psychiatric Services

LBN: Koinonia Healthcare
Koinonia Primary Care And Psychiatric Services is an health care organization with primary practice located at 553 Clinton Avenue , Albany NY 12206. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Koinonia Healthcare can be contacted via phone (518) 689-0282, or through Paeglow, Robert John via phone (518) 689-0282.

Contact Information

Primary practice address
553 Clinton Avenue Albany NY 12206
Phone: (518) 689-0282
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Paeglow, Robert John Doctor of Medicine (MD)
Phone: (518) 689-0282

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 60/201542 New York

Profile Details

NPI number 1225122054
LBN Legal business name Koinonia Healthcare
DBA Doing business as Koinonia Primary Care And Psychiatric Services
Authorized official Paeglow, Robert John Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Nov 3rd, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225122054 NPPES
New York MEDICAID 01753680
New York Other G9202

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