Healthcare Provider Details

I. General information

NPI: 1043662299
Provider Name (Legal Business Name): CARLOS FRANCISCO MARES BELTRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 NEW SCOTLAND AVE FL 4
ALBANY NY
12208-3795
US

IV. Provider business mailing address

22 NEW SCOTLAND AVE FL 4
ALBANY NY
12208-3795
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5214
  • Fax:
Mailing address:
  • Phone: 518-262-5214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number301128-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207SG0207X
TaxonomyMedical Biochemical Genetics
License Number301128-01
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number301128-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: