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General NPI Number Information
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NPI Number | 1538350616
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Entity Type | Organization
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Legal Business Name | VET CENTER
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 17 COMPUTER DR W
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City | ALBANY
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State | NY
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Zip | 12205-1614
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Country | US
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Telephone | 518-626-5130
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Fax |
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Provider Business Mailing Address
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Address Line | 17 COMPUTER DR W
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City | ALBANY
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State | NY
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Zip | 12205-1614
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Country | US
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Telephone | 518-626-5130
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Fax |
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Authorized Official
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Title or Position | TEAM LEADER
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Name | MELODIE KRAHULA
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Credential |
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Telephone | 518-626-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number | 73-071874
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License Number State | NY
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