Healthcare Provider Details

I. General information

NPI: 1952411126
Provider Name (Legal Business Name): ALBANY GASTROENTEROLOGY CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 WASHINGTON AVE SUITE 101
ALBANY NY
12206-1056
US

IV. Provider business mailing address

1375 WASHINGTON AVE SUITE 101
ALBANY NY
12206-1056
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: WILLIAM MICHAEL NOTIS
Title or Position: CEO
Credential: M.D.
Phone: 518-438-4483