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General NPI Number Information
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NPI Number | 1770307670
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Entity Type | Organization
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Legal Business Name | EMPIRE BARIATRICS PLLC
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 7 SOUTHWOODS BLVD STE 2
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City | ALBANY
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State | NY
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Zip | 12211-2526
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Country | US
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Telephone | 518-641-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 5 SOUTHSIDE DR STE 11
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3870
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Country | US
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Telephone | 315-575-3410
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | DR. MATTHEW DENNIS MCDONALD
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Credential | DO
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Telephone | 315-575-3410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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