Individual
JOHN R POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, 0203 MCAULEY, ALBANY, NY 12208-1707
(518) 525-1550
(518) 525-6545
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
231657
NY
208M00000X
Hospitalist Physician
Primary
231657
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02563202
—
NY
Enumeration date
08/15/2005
Last updated
06/09/2021
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