MEDICARE: SARATOGA REGIONAL MEDICAL , P.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0122X	Plastic and Reconstructive Surgery Physician

General Provider Information

NPI Number	:	1669289906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARATOGA REGIONAL MEDICAL , P.C

Provider Business Mailing Address
First Line	:	211 CHURCH ST
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-1090
Country	:	US
Telephone Number	:	518-886-5296
Fax Number	:

Provider Business Practice Location Address
First Line	:	3050 ROUTE 50 STE 201
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-2964
Country	:	US
Telephone Number	:	518-587-3222
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	ROBERT DONNARUMMA
Credential	:	MD
Telephone Number	:	518-587-1141

Provider Enumeration Date	:	12/11/2024
Last Update Date	:	12/11/2024

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