Provider Demographics
NPI:1578581203
Name:ALBANY MEMORIAL ANESTHESIOLOGISTS PC
Entity Type:Organization
Organization Name:ALBANY MEMORIAL ANESTHESIOLOGISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DANKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-785-6171
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0829
Mailing Address - Country:US
Mailing Address - Phone:518-785-6171
Mailing Address - Fax:518-785-6219
Practice Address - Street 1:600 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204
Practice Address - Country:US
Practice Address - Phone:518-785-6171
Practice Address - Fax:518-785-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00470457Medicaid
33386AMedicare ID - Type Unspecified
33386AMedicare UPIN