Healthcare Provider Details

I. General information

NPI: 1619966959
Provider Name (Legal Business Name): JAMES V MCDONALD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EMPIRE STATE PLAZA
ALBANY NY
12237-1836
US

IV. Provider business mailing address

EMPIRE STATE PLAZA COMMISSIONER'S OFFICE
ALBANY NY
12237-0627
US

V. Phone/Fax

Practice location:
  • Phone: 518-473-1166
  • Fax:
Mailing address:
  • Phone: 184-731-1665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number186383
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: