Healthcare Provider Details

I. General information

NPI: 1275927766
Provider Name (Legal Business Name): DR. ROBERT O'LEARY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1367 WASHINGTON AVE STE 200
ALBANY NY
12206-1048
US

IV. Provider business mailing address

1367 WASHINGTON AVE STE 200
ALBANY NY
12206-1048
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-2666
  • Fax: 518-701-2929
Mailing address:
  • Phone: 518-489-2666
  • Fax: 518-701-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number311784-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: