Organization
UPSTATE GASTROENTEROLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK M BRAUNSTEIN MD (CEO)
(518) 272-1199
Entity
Organization
Contact information
Practice address
2200 BURDETT AVE, TROY, NY 12180-2451
(518) 272-0234
(518) 272-0906
Mailing address
2200 BURDETT AVE, TROY, NY 12180-2451
(518) 272-0234
(518) 272-0906
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC9024
RAILROAD MEDICARE
NY
Enumeration date
07/27/2006
Last updated
05/09/2011
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