Healthcare Provider Details

I. General information

NPI: 1376816199
Provider Name (Legal Business Name): ALBANY GASTROENTEROLOGY CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2012
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 WASHINGTON AVENUE SUITE 101
ALBANY NY
11206-1040
US

IV. Provider business mailing address

1375 WASHINGTON AVENUE SUITE 101
ALBANY NY
11206-1040
US

V. Phone/Fax

Practice location:
  • Phone: 518-438-4483
  • Fax: 518-482-4201
Mailing address:
  • Phone: 518-438-4483
  • Fax: 518-482-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH CHOMA
Title or Position: MD
Credential: MD
Phone: 518-438-4483