Healthcare Provider Details

I. General information

NPI: 1114161213
Provider Name (Legal Business Name): MOLLY CATHERINE BOYD-SMITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE EMERGENCY MEDICINE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

47 NEW SCOTLAND AVE EMERGENCY MEDICINE
ALBANY NY
12208-3412
US

V. Phone/Fax

Practice location:
  • Phone: 845-222-3426
  • Fax:
Mailing address:
  • Phone: 845-222-3426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number62812
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number67903
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number67903
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number275890
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License Number275890
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: