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FRED C STORM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
259 LARK ST, ALBANY, NY 12210-1108
(518) 434-5678
Mailing address
195 BULOCK RD., SLINGERLANDS, NY 12159
(518) 439-3011

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
100428
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00301139
NY
Enumeration date
05/19/2006
Last updated
12/13/2011
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