Individual
ROBERT SOO-MIN PHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 PALISADES DR, ALBANY, NY 12205-1438
(518) 458-2000
(518) 458-1524
Mailing address
PO BOX 14890, ST. PETER'S HEALTH PARTNERS PAYER CREDENTIALING, ALBANY, NY 12212-4890
(518) 458-2000
(518) 458-1524
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
235501
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
235501
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02636657
—
NY
05
—
1017514
—
VT
Enumeration date
07/14/2005
Last updated
06/07/2021
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