Individual
BEN HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
315 S MANNING BLVD, ALBANY, NY 12208-1707
(518) 525-1693
Mailing address
38 ANDREW LN, MOUNT TREMPER, NY 12457-5315
(845) 332-0883
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
017379
NY
Other
Enumeration date
06/06/2014
Last updated
05/05/2021
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