ALBANY REGIONAL EYE SURGERY CENTER LLC NPI 1467407833

NPI Information

NPI: 1467407833
Provider Name: ALBANY REGIONAL EYE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

CLIA Number: 33D0990437

Address:
5 JOHNSON RD
LATHAM, NY
ZIP 12110
Phone: (518) 782-1181
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ALBANY REGIONAL EYE SURGERY CENTER, LLC is an ophthalmologic surgery clinic center in Latham, NY. ALBANY REGIONAL EYE SURGERY CENTER, LLC NPI is 1467407833. The provider is registered as an organization entity type.

The provider's business location address is:

5 JOHNSON RD
LATHAM, NY
ZIP 12110-003
Phone: (518) 782-1181

The provider's authorized official is Glenn De Brueys .
The authorized official title is Administrator and has the following contact phone number (518) 782-1181.

The CLIA number assigned to this NPI record is 33D0990437 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 11/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS0132X	Clinic/Center	Ophthalmologic Surgery	0153204R	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CC9531	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK	MEDICARE ID NUMBER
2	02214982	MEDICAID	NEW YORK
3	040191	OTHER	NEW YORK	EMPIRE BC ID NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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