Provider Demographics
NPI:1578115317
Name:CENTER FOR DONATION AND TRANSPLANT
Entity Type:Organization
Organization Name:CENTER FOR DONATION AND TRANSPLANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:THIBAULT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, BSN
Authorized Official - Phone:518-262-5606
Mailing Address - Street 1:218 GREAT OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5969
Mailing Address - Country:US
Mailing Address - Phone:518-262-5606
Mailing Address - Fax:518-262-5427
Practice Address - Street 1:218 GREAT OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5969
Practice Address - Country:US
Practice Address - Phone:518-262-5606
Practice Address - Fax:518-262-5427
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBANY MEDICAL COLLEGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335U00000XSuppliersOrgan Procurement Organization