1578659868 NPI number — ALBANY EYE ASSOCIATES PHYSICIANS & SURGEONS PC

Table of content: CAMBLEY NOELLE YALE PA (NPI 1427750710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578659868 NPI number — ALBANY EYE ASSOCIATES PHYSICIANS & SURGEONS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBANY EYE ASSOCIATES PHYSICIANS & SURGEONS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE EYE CENTER AT MEMORIAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578659868
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
63 SHAKER RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12204-1030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-434-1042
Provider Business Mailing Address Fax Number:
518-434-4327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
63 SHAKER RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12204-1030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-434-1042
Provider Business Practice Location Address Fax Number:
518-434-4327
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EBERLE
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
518-434-1042

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C30598 . This is a "RAILROAD MEDICARE PIN" identifier . This identifiers is of the category "OTHER".




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