Provider Demographics
NPI:1255660940
Name:ALBANY TROY CATARACT & LASER ASSOCIATES
Entity Type:Organization
Organization Name:ALBANY TROY CATARACT & LASER ASSOCIATES
Other - Org Name:OPHTHALMIC CONSULTANTS OF THE CAPITAL REGION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZIEKER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-274-3123
Mailing Address - Street 1:2500 POND VW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:S SCHODACK
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9750
Mailing Address - Country:US
Mailing Address - Phone:518-477-2391
Mailing Address - Fax:518-477-2393
Practice Address - Street 1:3 ATRIUM DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1417
Practice Address - Country:US
Practice Address - Phone:518-438-5273
Practice Address - Fax:518-438-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006705332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
J100000417Medicare PIN
NYJ400067746Medicare PIN
6367890002Medicare NSC
NYJ400163125Medicare PIN
NYJ400191644Medicare PIN
NY56834BMedicare PIN
NYJ400005114Medicare PIN
NYJ400006187Medicare PIN
NYJ400229517Medicare PIN
NYJ400154847Medicare PIN
NYJ400005159Medicare PIN
NYJ400030871Medicare PIN
NYJ400041159Medicare PIN
NYJ400056586Medicare PIN
NYJ400005161Medicare PIN