Healthcare Provider Details

I. General information

NPI: 1770990343
Provider Name (Legal Business Name): ALBANY FAMILY FOOT AND ANKLE SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692 CENTRAL AVE
ALBANY NY
12205-4045
US

IV. Provider business mailing address

1692 CENTRAL AVE
ALBANY NY
12205-4045
US

V. Phone/Fax

Practice location:
  • Phone: 518-869-5799
  • Fax:
Mailing address:
  • Phone: 518-869-5799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: ANNA KUPRIYEVA
Title or Position: DPM/OWNER
Credential: DPM
Phone: 518-869-5799