Individual
BRUNO P TOLGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 UNION ST, SCHENECTADY, NY 12308-3009
(518) 381-9202
(518) 381-1182
Mailing address
1563 UNION ST, SCHENECTADY, NY 12309-6022
(518) 377-3742
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
088151
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000413015005
BS NENY PROVIDER #
NY
05
—
00373340
—
NY
01
—
10002049
CDPHP
NY
01
—
13106
MVP PROVIDER #
NY
01
—
630N11
EMPIRE BC PROVIDER #
NY
Enumeration date
02/28/2007
Last updated
07/09/2007
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