Individual
ROBERT DANIEL DESIDERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 PARK ST, GLENS FALLS, NY 12801-4413
(518) 926-3120
Mailing address
257 SCHWERDTFEGER RD, PUTNAM STATION, NY 12861-2911
(518) 547-8722
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
196286
NY
Other
Enumeration date
04/05/2007
Last updated
07/08/2007
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