Healthcare Provider Details

I. General information

NPI: 1568575025
Provider Name (Legal Business Name): CAPITAL NEUROLOGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PATROON CREEK BLVD SUITE 210
ALBANY NY
12206-5013
US

IV. Provider business mailing address

400 PATROON CREEK BLVD SUITE 210
ALBANY NY
12206-5013
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE P. CORBETT
Title or Position: PRESIDENT
Credential: D.O.
Phone: 518-459-8106