Healthcare Provider Details

I. General information

NPI: 1003815184
Provider Name (Legal Business Name): ARMIN AFSAR-KESHMIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MURRAY ST
GLENS FALLS NY
12801-4311
US

IV. Provider business mailing address

7 MURRAY ST
GLENS FALLS NY
12801-4311
US

V. Phone/Fax

Practice location:
  • Phone: 518-743-1010
  • Fax: 518-793-5916
Mailing address:
  • Phone: 518-743-1010
  • Fax: 518-743-1018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberL235344
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: