Healthcare Provider Details

I. General information

NPI: 1356336663
Provider Name (Legal Business Name): MARC DAVID GINSBURG DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 HACKETT BLVD
ALBANY NY
12209-1525
US

IV. Provider business mailing address

104 HACKETT BLVD
ALBANY NY
12209-1525
US

V. Phone/Fax

Practice location:
  • Phone: 518-465-3515
  • Fax: 518-465-9857
Mailing address:
  • Phone: 518-465-3515
  • Fax: 518-465-9857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number3861
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number3861
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: