Healthcare Provider Details

I. General information

NPI: 1346209418
Provider Name (Legal Business Name): JOHN PATRICK VERDINI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PATROON CREEK BLVD SUITE 210
ALBANY NY
12206-5012
US

IV. Provider business mailing address

2 NEW HAMPSHIRE AVE SUITE 200
TROY NY
12180-1753
US

V. Phone/Fax

Practice location:
  • Phone: 518-459-8106
  • Fax: 518-489-6441
Mailing address:
  • Phone: 518-274-1947
  • Fax: 518-274-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number179399
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: