Provider Demographics
NPI:1770990343
Name:ALBANY FAMILY FOOT AND ANKLE SERVICES PC
Entity type:Organization
Organization Name:ALBANY FAMILY FOOT AND ANKLE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPRIYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-869-5799
Mailing Address - Street 1:1692 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4045
Mailing Address - Country:US
Mailing Address - Phone:518-869-5799
Mailing Address - Fax:
Practice Address - Street 1:1692 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4045
Practice Address - Country:US
Practice Address - Phone:518-869-5799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty