Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 208187 | NY |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 208187 | NY |
NPI | 1063411783 |
---|---|
Provider Name | Dr. Alfonso F.j. Prieto |
First Address | Albany, NY 12205-1438 |
Second Address | Albany, NY 12205-1438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 29/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02104209 | (05) | NY |
1017519 | (05) | VT |
H26450 | (02) |