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Individual

DR. MARK LESTER FRUITERMAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1365 WASHINGTON AVE, STE 300, ALBANY, NY 12206-1098
(518) 489-4704
(518) 489-0512
Mailing address
1365 WASHINGTON AVE, STE 300, ALBANY, NY 12206-1098
(518) 489-4704
(518) 489-0512

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
116938
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00438459
NY
Enumeration date
05/23/2005
Last updated
07/08/2007
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