Individual
DR. VADIM DIVILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 PALISADES DR STE 100, ALBANY, NY 12205-6433
(518) 438-4496
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
294602
NY
Other
Enumeration date
05/14/2015
Last updated
10/01/2024
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