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NPI Code Detail

MEDICARE: CAPITAL REGION UROLOGICAL SURGEONS

MEDICARE: CAPITAL REGION UROLOGICAL SURGEONS
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
1174400000XSpecialist

General Provider Information

NPI Number : 1700131992
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAPITAL REGION UROLOGICAL SURGEONS
Provider Business Mailing Address
First Line : 319 S MANNING BLVD
Second Line : SUITE 106
City : ALBANY
State : NY
Zip : 12208-1742
Country : US
Telephone Number : 518-438-0507
Fax Number :
Provider Business Practice Location Address
First Line : 19 WEST AVE
Second Line :
City : SARATOGA SPGS
State : NY
Zip : 12866-6049
Country : US
Telephone Number : 518-583-0111
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : JENNIFER YATES
Credential :
Telephone Number : 518-438-0507
Provider Enumeration Date : 07/13/2012
Last Update Date : 07/19/2012

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Directions to “CAPITAL REGION UROLOGICAL SURGEONS ” Practice Location

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