Basic Information
Provider Information
NPI: 1861493660
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOYLE
FirstName: TODD
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 PATROON CREEK BLVD
Address2: SUITE 1
City: ALBANY
State: NY
PostalCode: 122065004
CountryCode: US
TelephoneNumber: 5184890044
FaxNumber:  
Practice Location
Address1: 400 PATROON CREEK BLVD
Address2: SUITE 1
City: ALBANY
State: NY
PostalCode: 122065004
CountryCode: US
TelephoneNumber: 5184890044
FaxNumber: 5184893591
Other Information
ProviderEnumerationDate: 08/03/2005
LastUpdateDate: 03/19/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X220565NYY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


Home