Individual
LANCE EUGENE SULLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 SOUTHWOODS BLVD, CAPITAL CARDIOLOGY ASSOCIATES, PC, ALBANY, NY 12211-2526
(518) 292-6000
(518) 292-6050
Mailing address
7 SOUTHWOODS BLVD, CAPITAL CARDIOLOGY ASSOCIATES, PC, ALBANY, NY 12211-2526
(518) 292-6000
(518) 292-6050
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101058708
VA
207RC0000X
Cardiovascular Disease Physician
Primary
247198
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02961168
—
NY
05
—
1015882
—
VT
05
—
2156164
—
MA
01
—
P00679142
MEDICARE, RAILROAD
NY
Enumeration date
09/22/2006
Last updated
01/30/2015
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