JUSTIN POTTER PENDERGRAST

ALBANY, NY
NPI1972692887
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  009621)
Additional Taxonomies363AS0400X Physician Assistant Surgical
(Licence: NY  009621)
Enumeration Date2006-10-11
Last Update Date2008-07-15
Business Address
MR. JUSTIN POTTER PENDERGRAST PA-C
43 NEW SCOTLAND AVE
ALBANY, NY 12208-3412
Phone number: 518-262-6575
Mailing Address
MR. JUSTIN POTTER PENDERGRAST PA-C
1462 ERIE BLVD
SCHENECTADY, NY 12305-1026
Phone number: 518-243-1020