Provider Demographics
NPI:1336146844
Name:MICHALEK, ANN VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:VICTORIA
Last Name:MICHALEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SOUTHWOODS BLVD
Mailing Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2526
Mailing Address - Country:US
Mailing Address - Phone:518-292-6000
Mailing Address - Fax:518-641-6766
Practice Address - Street 1:7 SOUTHWOODS BLVD
Practice Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2526
Practice Address - Country:US
Practice Address - Phone:518-292-6000
Practice Address - Fax:518-641-6766
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145827207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5926738OtherAETNA
NY041006000033OtherFIDELIS CARE
NY286637OtherUHC
NY4124265OtherMOHAWK VALLEY PHP
NY00893398Medicaid
NY0110234412OtherRR MEDICARE
NY000406195005OtherBS NENY
NY271066OtherWELLCARE
NY3156R1OtherEBCBS
NY10010031OtherCDPHP
NY145827OtherSHARED HEALTH NETWORK
MA2086794Medicaid
NY4124265OtherMOHAWK VALLEY PHP
NY3156R1OtherEBCBS
B82589Medicare UPIN