Provider Demographics
NPI:1215910187
Name:ALBANESE, ANTHONY PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PAUL
Last Name:ALBANESE
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:10535 HOSPITAL WAY
Mailing Address - Street 2:SACRAMENTO VA MEDICAL CENTER, GI DIVISION, SMAT/111
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655-4200
Mailing Address - Country:US
Mailing Address - Phone:916-366-5451
Mailing Address - Fax:916-366-5376
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:SACRAMENTO VA MEDICAL CENTER, GI DIVISION, SMAT/111
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:916-366-5451
Practice Address - Fax:916-366-5376
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY171345207RA0401X
CAG71057207RG0100X
FLME0059121207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Not Answered207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E20420Medicare UPIN
18158XYZMedicare ID - Type Unspecified