Healthcare Provider Details

I. General information

NPI: 1053637728
Provider Name (Legal Business Name): JOSEPH THOMAS VUKOVIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE EMERGENCY DEPARTMENT
ALBANY NY
12208-3412
US

IV. Provider business mailing address

47 NEW SCOTLAND AVE EMERGENCY DEPARTMENT
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number267012
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number61026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: