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General NPI Number Information
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NPI Number | 1063229458
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Entity Type | Organization
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Legal Business Name | TWIN RIVERS MEDICAL PC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 7 SOUTHWOODS BLVD
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City | ALBANY
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State | NY
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Zip | 12211-2514
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Country | US
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Telephone | 518-641-6580
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Fax | 518-292-6088
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Provider Business Mailing Address
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Address Line | 7 SOUTHWOODS BLVD
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City | ALBANY
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State | NY
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Zip | 12211-2514
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Country | US
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Telephone | 518-641-6580
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | CARL W DOBSON
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Credential |
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Telephone | 802-447-4535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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