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General NPI Number Information
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NPI Number | 1477992873
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Entity Type | Individual
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Provider Name | CRAIG THOMAS FOURNIER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 100 GREAT OAKS BLVD STE 103
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City | ALBANY
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State | NY
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Zip | 12203-7924
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Country | US
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Telephone | 518-414-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 5 FIELDSTONE DR
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City | DELMAR
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State | NY
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Zip | 12054-6703
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Country | US
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Telephone | 207-318-4583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 309952
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License Number State | NY
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