Provider Demographics
NPI:1407847841
Name:DOANE, MADELEINE ROBINSON (PA)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:ROBINSON
Last Name:DOANE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-0304
Mailing Address - Country:US
Mailing Address - Phone:518-499-1215
Mailing Address - Fax:518-499-1712
Practice Address - Street 1:99 BUCKLEY RD
Practice Address - Street 2:WHITEHALL ELEMENTARY SCHOOL
Practice Address - City:WHITEHALL
Practice Address - State:NY
Practice Address - Zip Code:12887-3633
Practice Address - Country:US
Practice Address - Phone:518-499-1215
Practice Address - Fax:518-499-1712
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001511363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02347762Medicaid
NYP00009676OtherRR MEDICARE
NYCC1154Medicare PIN
NYP00009676OtherRR MEDICARE