Provider Demographics
NPI:1336389295
Name:ALBANY TROY CATARACT & LASER ASSOCIATES
Entity Type:Organization
Organization Name:ALBANY TROY CATARACT & LASER ASSOCIATES
Other - Org Name:OPHTHALMIC CONSULTANTS OF THE CAPITAL REGION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-274-3123
Mailing Address - Street 1:2500 POND VW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:S SCHODACK
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9750
Mailing Address - Country:US
Mailing Address - Phone:518-477-2391
Mailing Address - Fax:518-477-2393
Practice Address - Street 1:2222 6TH AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2203
Practice Address - Country:US
Practice Address - Phone:518-274-3123
Practice Address - Fax:518-271-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
NY006705332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DP2419OtherMEDICARE RAILROAD
NYJ400041159Medicare PIN
NYJ400056586Medicare PIN
NYJ900000003Medicare PIN
NY33768BMedicare PIN
6367890001Medicare NSC
NYA400067768Medicare PIN
J400005115Medicare PIN
J400005161Medicare PIN
NYJ400154847Medicare PIN
NYJ400030871Medicare PIN
NY56834BMedicare PIN
J400006187Medicare PIN
J400006831Medicare PIN
DP2419OtherMEDICARE RAILROAD
J400005159Medicare PIN
NYJ400024502Medicare PIN
NYJ400050016Medicare PIN
P00740623Medicare PIN
NYJ100000417Medicare PIN