Provider Demographics
NPI:1689722746
Name:MCDONALD, JOHN TERRANCE III (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:TERRANCE
Last Name:MCDONALD
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-4013
Mailing Address - Country:US
Mailing Address - Phone:518-233-8208
Mailing Address - Fax:
Practice Address - Street 1:217 REMSEN ST
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-3024
Practice Address - Country:US
Practice Address - Phone:518-233-8208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist