Individual
DR. FABIO LEONIDAS URRESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
3 NEWCASTLE RD, HALFMOON, NY 12065-6123
(518) 724-5151
(518) 207-9078
Mailing address
3 NEWCASTLE RD, HALFMOON, NY 12065-6123
(518) 724-5151
(518) 207-9078
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
247163
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000417902002
BLUE SHIELD OF NORTHEASTERN NEW YORKI
NY
01
—
0046572
EMPIRE BLUE CROSS BLUE SHIELD
NY
01
—
05446216
ECFMG
—
01
—
1104987064
MEDICARE INDIVIDUAL
NY
01
—
1891946323
MEDICARE GROUP
NY
01
—
533029
CIGNA BEHAVIORAL HEALTH
NY
01
—
6022352
MVP
NY
01
—
605560
VALUE OPTIONS
NY
Enumeration date
12/13/2006
Last updated
04/12/2023
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