Provider Demographics
NPI:1528204336
Name:VANGUARD MEDICAL OF CAPITAL DISTRICT PLLC
Entity Type:Organization
Organization Name:VANGUARD MEDICAL OF CAPITAL DISTRICT PLLC
Other - Org Name:VANGUARD MEDICAL OF CAPITAL DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-225-2551
Mailing Address - Street 1:1010 NEW LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-5004
Mailing Address - Country:US
Mailing Address - Phone:518-220-9007
Mailing Address - Fax:518-220-9166
Practice Address - Street 1:1010 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-5004
Practice Address - Country:US
Practice Address - Phone:518-220-9007
Practice Address - Fax:518-220-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2340822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty