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Organization
UPSTATE MEDICAL GROUP PC
Active
Organization
UPSTATE MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY TROITINO MD (PRESIDENT)
(518) 237-9708
Entity
Organization
Contact information
Practice address
2231 BURDETT AVE, SUITE 120, TROY, NY 12180
(518) 237-9708
Mailing address
2231 BURDETT AVE, SUITE 120, TROY, NY 12180
(518) 237-9708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8644
MEDICARE ID
—
01
—
CH8587
MEDICARE ID
—
Enumeration date
04/28/2006
Last updated
06/29/2010
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