Healthcare Provider Details

I. General information

NPI: 1497954473
Provider Name (Legal Business Name): SURYA PHYSICALS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 EVERETT RD EXT
ALBANY NY
12205-3357
US

IV. Provider business mailing address

21 EVERETT RD EXT
ALBANY NY
12205-3357
US

V. Phone/Fax

Practice location:
  • Phone: 518-867-8080
  • Fax: 518-867-8088
Mailing address:
  • Phone: 518-867-8080
  • Fax: 518-867-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GIRIDHAR CHOLPADY KAMATH
Title or Position: PRESIDENT
Credential: DO
Phone: 518-867-8080