Provider Demographics
NPI:1609192061
Name:BARRY, SUZANNE MCGRORTY (DO)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MCGRORTY
Last Name:BARRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:MCGRORTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:47 NEW SCOTLAND AVE MC88
Mailing Address - Street 2:AMC PEDIATRIC CRITICAL CARE GROUP
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-262-5568
Mailing Address - Fax:
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289786208000000X, 282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No208000000XAllopathic & Osteopathic PhysiciansPediatrics