Ephraim E Back (NPI# 1649295254, PAC ID# 0547228009) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1649295254 |
| PAC ID by PECOS | 0547228009 |
| Professional Enrollment ID | I20041230000026 |
| Full Name | Ephraim E Back |
| Organization Legal Name | HUDSON HEADWATERS HEALTH NETWORK |
| Address |
102 Race Track Rd Suite 1 Ticonderoga NY 12883-4004 |
| Phone Number | 5185856708 |
| Gender | M |
| Credential | MD |
| Medical School | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7416861208 |
| Number of Group Practice Members | 137 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 331302 | ELIZABETHTOWN COMMUNITY HOSPITAL |
| 330191 | GLENS FALLS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 | 5185856708 | HUDSON HEADWATERS HEALTH NETWORK |
| Organization Legal Name | HUDSON HEADWATERS HEALTH NETWORK |
| Physicians | 152 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Esterson | Family Medicine | Hudson Headwaters Health Network | 828 State Route 11, Champlain, NY 12919-4966 |
| Ashley Claire Eleanor Bernotas | Family Medicine | Hudson Headwaters Health Network | 87 Plaza Blvd, Plattsburgh, NY 12901-6438 |
| Cassie Elaine Leonard | Obstetrics/gynecology | Hudson Headwaters Health Network | 90 S St, Glens Falls, NY 12801-4353 |
| Sarah M Thompson | Family Medicine | Hudson Headwaters Health Network | 6223 State Route 9, Chestertown, NY 12817-2823 |
| Kristine Blais Alix | Nurse Practitioner | Hudson Headwaters Health Network | 11 Cross St, Bolton Landing, NY 12814-7711 |
| Rita L All | Nurse Practitioner | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Maurice A Racine | Family Medicine | Hudson Headwaters Health Network | 24 Fairfield Ave, Schroon Lake, NY 12870-0292 |
| Christopher H Jackson | Physician Assistant | Hudson Headwaters Health Network | 126 Ski Bowl Rd, North Creek, NY 12853-2607 |
| Howard E Silverberg | Internal Medicine | Hudson Headwaters Health Network | 48 E St, Fort Edward, NY 12828-1811 |
| Harriet Busch | Family Practice | Hudson Headwaters Health Network | 14 Manor Dr, Queensbury, NY 12804-1906 |
| Street Address |
102 RACE TRACK RD SUITE 1 |
| City | TICONDEROGA |
| State | NY |
| Zip | 12883-4004 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Glen D Chapman | Family Medicine | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Michael J Rumbutis | Physician Assistant | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Jill Marie Geoffrion | Physician Assistant | Hudson Headwaters Health Network | 102 Race Track Rd, Ticonderoga, NY 12883-4004 |
| Elizabeth Anderson | Nurse Practitioner | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Loren M Allen | Nurse Practitioner | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Dennis S O'brien | Internal Medicine | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Janine Nicole Gadjo | Nurse Practitioner | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| James O Gabler | Physician Assistant | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Richard N Mckeever | Family Practice | Hudson Headwaters Health Network | 102 Race Track Rd, Suite 1, Ticonderoga, NY 12883-4004 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jan E Duus | Hematology/oncology | Lake Champlain Physician Services | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| James S Kenney | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Eric B Herskowitz | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Curt M Snyder | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Wolodymyr I Bula | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Albert M Imobersteg | Orthopedic Surgery | Lake Champlain Physician Services | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Jeffrey J Buran | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Michael E Phillips | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Anthony G Conti | Diagnostic Radiology | Associates In Radiology of Plattsburgh Ny PC | 1019 Wicker St, Ticonderoga, NY 12883-1039 |
| Bradbury Fuller | General Surgery | 1019 Wicker St, Ticonderoga, NY 12883-1039 | |
| Find all physicians in zip 12883 | |||
| City | TICONDEROGA |
| Zip Code | 12883 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | TICONDEROGA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Ephraim E Back.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.