Basic Information
Provider Information | |||||||||
NPI: | 1326466244 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | NEW YORK ONCOLOGY HEMATOLOGY PC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 400 PATROON CREEK BLVD | ||||||||
Address2: | SUITE 1 | ||||||||
City: | ALBANY | ||||||||
State: | NY | ||||||||
PostalCode: | 122065013 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5184890044 | ||||||||
FaxNumber: | 5184893591 | ||||||||
Practice Location | |||||||||
Address1: | 400 PATROON CREEK BLVD | ||||||||
Address2: | SUITE 1 | ||||||||
City: | ALBANY | ||||||||
State: | NY | ||||||||
PostalCode: | 122065013 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5184890044 | ||||||||
FaxNumber: | 5184893591 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/29/2014 | ||||||||
LastUpdateDate: | 06/23/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | DOYLE | ||||||||
AuthorizedOfficialFirstName: | TODD | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 5184890044 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | Y | ||||||||
ParentOrganizationLBN: | NEW YORK ONCOLOGY HEMATOLOGY PC | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | M.D. | ||||||||
NPICertificationDate: | 06/23/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X |   |   | Y |   | Suppliers | Non-Pharmacy Dispensing Site |   |
No ID Information.