Healthcare Provider Details

I. General information

NPI: 1710989249
Provider Name (Legal Business Name): JOCELYN CELESTIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WASHINGTON AVENUE EXT
ALBANY NY
12205-5534
US

IV. Provider business mailing address

176 WASHINGTON AVENUE EXT
ALBANY NY
12203-5300
US

V. Phone/Fax

Practice location:
  • Phone: 518-452-2510
  • Fax: 518-452-2683
Mailing address:
  • Phone: 518-264-2510
  • Fax: 518-264-2520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number204070-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number204070-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: