Provider Demographics
NPI:1033122551
Name:POWE, EMILE ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILE
Middle Name:ALLEN
Last Name:POWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12204-1738
Mailing Address - Country:US
Mailing Address - Phone:518-436-9705
Mailing Address - Fax:518-432-9403
Practice Address - Street 1:692 N PEARL ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204-1738
Practice Address - Country:US
Practice Address - Phone:518-436-9705
Practice Address - Fax:518-432-9403
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127515207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00862675Medicaid
NY40076BMedicare ID - Type Unspecified
NYB82664Medicare UPIN