Organization
CAPITAL REGION UROLOGICAL SURGEONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER A YATES (BILLING DIRECTOR)
(518) 438-0507
Entity
Organization
Contact information
Practice address
319 S MANNING BLVD, ALBANY, NY 12208-1742
(518) 438-1019
(518) 438-0981
Mailing address
319 S MANNING BLVD, ALBANY, NY 12208-1743
(518) 438-1019
(518) 438-0981
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RAILROAD MEDICARE
DE4191
—
Enumeration date
06/04/2006
Last updated
06/03/2015
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