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Organization

STATE OF NEW YORK

Active
Other names
UA-SUNY Sports Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
GERARD KOLOSKIE (AUTHORIZED OFFICIAL)
(518) 591-8566
Entity
Organization

Contact information

Practice address
1400 WASHINGTON AVE, ALBANY, NY 12222-0100
(972) 367-4845
Mailing address
15305 DALLAS PKWY STE 800, ADDISON, TX 75001-6415
(972) 367-4845

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
07/23/2018
Last updated
04/05/2022
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