Individual
DR. JEFFREY DANIEL TABBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 PINNACLE PL, SUITE 102, ALBANY, NY 12203-3496
(518) 689-0244
(518) 689-0241
Mailing address
1 PINNACLE PL, SUITE 102, ALBANY, NY 12203-3496
(518) 689-0244
(518) 689-0241
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
192245
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC1930
MEDICARE PTAN
NY
Enumeration date
09/23/2008
Last updated
02/22/2009
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