Individual
DR. PAUL H LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 MASSACHUSETTS AVE, TROY, NY 12180-1628
(518) 268-6406
(518) 268-6294
Mailing address
PO BOX 689, TROY, NY 12181-0689
(518) 268-5000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
156804
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00951648
—
NY
Enumeration date
08/16/2005
Last updated
09/16/2009
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