Provider Demographics
NPI:1346209418
Name:VERDINI, JOHN PATRICK (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:VERDINI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1753
Mailing Address - Country:US
Mailing Address - Phone:518-274-1947
Mailing Address - Fax:518-274-2339
Practice Address - Street 1:400 PATROON CREEK BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-5012
Practice Address - Country:US
Practice Address - Phone:518-459-8106
Practice Address - Fax:518-489-6441
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2012-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1793992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY013866869Medicaid
NY50348JMedicare ID - Type Unspecified
NY013866869Medicaid
NYF18118Medicare UPIN