Healthcare Provider Details

I. General information

NPI: 1609192061
Provider Name (Legal Business Name): SUZANNE MCGRORTY BARRY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUZANNE MARIE MCGRORTY DO

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

47 NEW SCOTLAND AVE MC88 AMC PEDIATRIC CRITICAL CARE GROUP
ALBANY NY
12208
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5568
  • Fax:
Mailing address:
  • Phone: 518-262-5568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number289786
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number289786
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: