Individual
ANGELO ALGAS POTENCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, 3-CUSACK RM 3503, ALBANY, NY 12208-1707
(518) 525-1304
Mailing address
315 S MANNING BLVD, 3-CUSACK RM 3503, ALBANY, NY 12208-1707
(518) 525-1304
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
224873
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10084930
CDPHP
NY
01
—
4144957
MVP
NY
Enumeration date
07/08/2006
Last updated
07/21/2022
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