Healthcare Provider Details

I. General information

NPI: 1336389295
Provider Name (Legal Business Name): ALBANY TROY CATARACT & LASER ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 6TH AVE
TROY NY
12180-2203
US

IV. Provider business mailing address

2500 POND VW SUITE 101
S SCHODACK NY
12033-9750
US

V. Phone/Fax

Practice location:
  • Phone: 518-274-3123
  • Fax: 518-271-0624
Mailing address:
  • Phone: 518-477-2391
  • Fax: 518-477-2393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number006705
License Number StateNY

VIII. Authorized Official

Name: ALLEN ZIEKER
Title or Position: MD
Credential: MD
Phone: 518-274-3123