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Organization
ISIDRO M BULATAO MD PC
Active
Organization
ISIDRO M BULATAO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISIDRO M BULATAO MD (PRESIDENT)
(518) 235-3990
Entity
Organization
Contact information
Practice address
190 5TH AVE, TROY, NY 12180
(518) 235-3990
(518) 235-9177
Mailing address
PO BOX 986, LATHAM, NY 12110
(518) 235-3990
(518) 235-9177
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
097438
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00529300
—
NY
01
—
10000230
CDPHP
NY
01
—
20365
BLUE CROSS
NY
Enumeration date
04/16/2007
Last updated
08/22/2020
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