Individual
KHOA NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
16 NEW SCOTLAND AVE, ALBANY, NY 12208-3504
(518) 262-5345
Mailing address
16 NEW SCOTLAND AVE, ALBANY, NY 12208-3504
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
305553
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
03/04/2015
Last updated
01/29/2021
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