Upstate Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

122852 Issued in NY

Legal business name

UPSTATE MEDICAL GROUP

Practice address

2 Emma LN
Suite 2
Clifton Park, NY 12065-3763

Phone

(518) 383-4198

NPI assigned

Mar 7, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Troitino

Title

President

Phone

(518) 383-4198

Specialties & licenses 1

Addresses

Tax ID family

Upstate Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Upstate Medical Group

  • Internal Medicine Physician
  • Troy, NY
  • NPI 1013283951
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1649544750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EMMA LN",
            "address_2": "SUITE 2",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653763",
            "telephone_number": "518-383-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMMA LN",
            "address_2": "SUITE 2",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653763",
            "telephone_number": "518-383-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "TROITINO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-383-4198",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "122852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.