Healthcare Provider Details

I. General information

NPI: 1639155153
Provider Name (Legal Business Name): GHULAM A. AKBARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ATRIUM DR SUITE 100; ATTN: TAMMY M. BUTTON
ALBANY NY
12205-1441
US

IV. Provider business mailing address

315 S MANNING BLVD HOSPITALIST PROGRAM - 6 CUSACK
ALBANY NY
12208-1707
US

V. Phone/Fax

Practice location:
  • Phone: 518-435-2740
  • Fax: 518-458-2610
Mailing address:
  • Phone: 518-525-8600
  • Fax: 518-525-6891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number234939
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number234939
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: