Individual
DR. PAUL STANLEY FELLENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 KROSS KEYS DR, SUITE 103, ALBANY, NY 12205-1466
(518) 438-2751
(518) 438-2753
Mailing address
2 KROSS KEYS DR, SUITE 103, ALBANY, NY 12205-1466
(518) 438-2751
(518) 438-2753
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
208750
NY
207W00000X
Ophthalmology Physician
Primary
208750
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01912289
—
NY
Enumeration date
07/04/2006
Last updated
04/26/2011
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