Individual
EDGAR R. HENRIQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, 6 CUSACK, ALBANY, NY 12208-1707
(518) 525-8600
(518) 525-6891
Mailing address
4 ATRIUM DR, SUITE 100, ATTN: TAMMY M. BUTTON, ALBANY, NY 12205-1441
(518) 435-2740
(518) 458-2610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
231783
NY
208M00000X
Hospitalist Physician
231783
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02529371
—
NY
Enumeration date
08/10/2005
Last updated
04/29/2020
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