Individual
ERIK D ISTRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
161 CAREY RD, QUEENSBURY, NY 12804-7821
(518) 824-8610
(518) 824-2390
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
(518) 824-2388
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
283636
NY
2084P0800X
Psychiatry Physician
283636
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04529053
—
NY
Enumeration date
06/17/2010
Last updated
05/10/2021
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