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EDGAR S HENRIQUES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
130 EVERETT RD, ALBANY, NY 12205
(518) 482-1007
(518) 489-6210
Mailing address
130 EVERETT RD, ALBANY, NY 12205
(518) 482-1007
(518) 489-6210

Taxonomy

Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
114044
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000405379001
BLUE SHIELD
01
10000876
CDPHP
01
56359
BCBS
01
81520016186
MVP
Enumeration date
02/07/2007
Last updated
07/08/2007
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