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General NPI Number Information
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NPI Number | 1578115317
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Entity Type | Organization
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Legal Business Name | CENTER FOR DONATION AND TRANSPLANT
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 218 GREAT OAKS BLVD
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City | ALBANY
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State | NY
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Zip | 12203-5969
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Country | US
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Telephone | 518-262-5606
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Fax | 518-262-5427
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Provider Business Mailing Address
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Address Line | 218 GREAT OAKS BLVD
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City | ALBANY
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State | NY
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Zip | 12203-5969
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Country | US
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Telephone | 518-262-5606
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Fax | 518-262-5427
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MICHAEL R THIBAULT
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Credential | MBA, BSN
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Telephone | 518-262-5606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335U00000X
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Taxonomy Name | Organ Procurement Organization
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License Number |
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License Number State |
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