Individual
DR. GAETANO MATTHEW CRISTALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
279 TROY RD, FAMILY MEDICAL GROUP, RENSSELAER, NY 12144-9518
(518) 286-1922
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
262096
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473565
—
NY
Enumeration date
07/15/2010
Last updated
05/12/2021
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