Healthcare Provider Details

I. General information

NPI: 1770578031
Provider Name (Legal Business Name): JAMES J O'BRIEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAPITAL CARDIOLOGY ASSOCIATES PC 7 SOUTHWOODS BLVD
ALBANY NY
12211-2526
US

IV. Provider business mailing address

CAPITAL CARDIOLOGY ASSOCIATES PC 7 SOUTHWOODS BLVD
ALBANY NY
12211-2526
US

V. Phone/Fax

Practice location:
  • Phone: 518-292-6000
  • Fax: 518-292-6050
Mailing address:
  • Phone: 518-292-6000
  • Fax: 518-292-6050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number203505
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number203505
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: