MEDICARE: VINCENT R ALBANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1558872051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT R ALBANO

Provider Business Mailing Address
First Line	:	139 BALDWIN ST
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3872
Country	:	US
Telephone Number	:	973-650-0256
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 ROUTE 3 FL GROUND
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3928
Country	:	US
Telephone Number	:	862-591-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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Directions to “ VINCENT R ALBANO ” Practice Location

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