Provider Demographics
NPI:1649265620
Name:DR. JEFFREY ALTMAN'S OFFICE
Entity type:Organization
Organization Name:DR. JEFFREY ALTMAN'S OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-462-3936
Mailing Address - Street 1:66 HACKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1750
Mailing Address - Country:US
Mailing Address - Phone:518-462-3936
Mailing Address - Fax:518-462-4136
Practice Address - Street 1:66 HACKETT BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209-1750
Practice Address - Country:US
Practice Address - Phone:518-462-3936
Practice Address - Fax:518-462-4136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163449176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC59456Medicare UPIN
NYBA0844Medicare PIN