Koinonia Primary Care INC

NPI #1023389533 in Albany, New York

Provider Information

NPI Number: 1023389533
Entity Type: Organization
Organization Name: Koinonia Primary Care INC
Primary Specialty: Clinic/Center
Enumeration Date: Jan 16, 2012
Last Updated: Jan 16, 2012

Practice Location

Address: 553 CLINTON AVE
City: Albany
State: New York
ZIP Code: 12206-2738
Phone: (518) 689-0282

Authorized Official

Name: DR. ROBERT JOHN PAEGLOW, M.D.
Title: PRESIDENT
Phone: (518) 689-0282

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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