State Of New York Comptrollers Office

Specialty details in registry · Perrysburg, NY

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At a glance

10714 North Rd, Perrysburg, NY 14129-9746

NPPES record updated Jan 6, 2016. Public records can lag behind changes at a practice.

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Practice location

10714 North Rd
Perrysburg, NY 14129-9746

Professional details: NPI, taxonomy & registry record

NPI1790825586

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 261QD1600X
Enumeration date: Feb 8, 2007
Record updated: Jan 6, 2016

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

261QD1600X · Primary

License reported: 00279700 NY

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

10714 North Rd
Perrysburg, NY 14129-9746

Phone: (716) 532-1049

Mailing address

44 HOLLAND AVE

ALBANY, NY 122290001

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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