Provider Demographics
NPI:1740248707
Name:BARTOLETTI, ALBERT L (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:L
Last Name:BARTOLETTI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11 CARDONA CT
Mailing Address - Street 2:
Mailing Address - City:WESTERLO
Mailing Address - State:NY
Mailing Address - Zip Code:12193-2500
Mailing Address - Country:US
Mailing Address - Phone:518-525-6560
Mailing Address - Fax:518-525-6555
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:ST. PETER'S HOSPITAL
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1707
Practice Address - Country:US
Practice Address - Phone:518-525-6560
Practice Address - Fax:518-525-6555
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1307682080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00627692Medicaid