Healthcare Provider Details

I. General information

NPI: 1215010624
Provider Name (Legal Business Name): ANNE NOEL NAFZIGER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 CENTRAL AVENUE STE 201
ALBANY NY
12205-4773
US

IV. Provider business mailing address

1762 CENTRAL AVENUE STE 201
ALBANY NY
12205-4773
US

V. Phone/Fax

Practice location:
  • Phone: 518-389-1300
  • Fax: 716-214-4460
Mailing address:
  • Phone: 518-389-1300
  • Fax: 716-214-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number164871
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number164871
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: