Basic Information
| Provider Information | |||||||||
| NPI: | 1740364678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLE | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 391 MYRTLE AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182624942 | ||||||||
| FaxNumber: | 5182625291 | ||||||||
| Practice Location | |||||||||
| Address1: | 391 MYRTLE AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182624942 | ||||||||
| FaxNumber: | 5182625291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 04/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 178404 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.