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General NPI Number Information
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NPI Number | 1639132475
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Entity Type | Organization
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Legal Business Name | TROY ENDOCRINOLOGY PLLC
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 1304 PARK BLVD
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City | TROY
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State | NY
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Zip | 12180-1403
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Country | US
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Telephone | 518-273-3755
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Fax | 518-273-6865
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Provider Business Mailing Address
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Address Line | 1304 PARK BLVD
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City | TROY
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State | NY
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Zip | 12180-1403
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Country | US
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Telephone | 518-273-3755
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAJINDER JAIN
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Credential | M.D.
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Telephone | 518-273-3755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 127826
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License Number State | NY
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