Individual
LOUIS PETER DECUNZO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14 HUDSON AVENUE, SURGICAL SPECIALISTS OF GLENS FALLS HOSPITAL, GLENS FALLS, NY 12801-4443
(518) 926-5600
(518) 926-5605
Mailing address
100 PARK STREET, GLENS FALLS, NY 12801-4413
(518) 926-5924
(518) 926-6983
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
201484
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01617601
—
NY
01
—
P00402831
RR MEDICARE
NY
Enumeration date
11/17/2005
Last updated
02/10/2022
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