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Individual

PETER NAMKOONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1365 WASHINGTON AVE, SUITE 201, ALBANY, NY 12206-1068
(518) 489-4446
(518) 489-4448
Mailing address
1365 WASHINGTON AVE, SUITE 201, ALBANY, NY 12206-1068
(518) 489-4446
(518) 489-4448

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
213838
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01956514
NY
01
10030727
CDPHP PROVIDER #
NY
01
15901
MVP PROVIDER #
NY
01
160055710
RAILROAD MEDICARE
NY
Enumeration date
04/13/2006
Last updated
01/31/2012
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