Provider Demographics
NPI:1851364087
Name:BARTOLI, ALBERTO M (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:M
Last Name:BARTOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4545
Mailing Address - Country:US
Mailing Address - Phone:607-772-8020
Mailing Address - Fax:607-348-0079
Practice Address - Street 1:42 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4545
Practice Address - Country:US
Practice Address - Phone:607-772-8020
Practice Address - Fax:607-348-0079
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127959208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00433312Medicaid
NY00433312Medicaid
NY34528DMedicare ID - Type Unspecified