Organization
ALBANY UPSTATE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARIQ PASHA MALIK DDS (OWNER / DENTIST)
(518) 465-0808
Entity
Organization
Contact information
Practice address
540 BROADWAY, 100, ALBANY, NY 12207-2708
(518) 465-0808
(518) 465-1450
Mailing address
540 BROADWAY, 100, ALBANY, NY 12207-2708
(518) 465-0808
(518) 465-1450
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
050817
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811906563
SOLE PROPERITER NPI
NY
Enumeration date
12/30/2013
Last updated
12/30/2013
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