Provider Demographics
NPI:1366684813
Name:TOOKE-BARRY, CHELSEA ERYN (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ERYN
Last Name:TOOKE-BARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ERYN
Other - Last Name:TOOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 8870
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-0870
Mailing Address - Country:US
Mailing Address - Phone:518-525-1474
Mailing Address - Fax:
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1707
Practice Address - Country:US
Practice Address - Phone:518-525-1474
Practice Address - Fax:518-525-6750
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131392207ZP0102X
PAMD450357207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology