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General NPI Number Information
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NPI Number | 1457080939
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Entity Type | Organization
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Legal Business Name | VIRTUAL PHYSICIAN PRACTICE NY PLLC
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 845 CENTRAL AVE STE 204
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City | ALBANY
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State | NY
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Zip | 12206-1514
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Country | US
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Telephone | 855-408-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 WASHTENAW AVE STE 280
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City | ANN ARBOR
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State | MI
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Zip | 48104-5184
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Country | US
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Telephone | 734-373-0849
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | LINDSAY BARKER
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Credential |
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Telephone | 734-373-0849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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