Provider Demographics
NPI:1063668895
Name:SIU, ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:SIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:526 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5564
Mailing Address - Country:US
Mailing Address - Phone:973-226-0500
Mailing Address - Fax:973-226-7221
Practice Address - Street 1:526 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5564
Practice Address - Country:US
Practice Address - Phone:973-226-0500
Practice Address - Fax:973-226-7221
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08434200207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine