Provider Demographics
NPI:1700865714
Name:MCKAY, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MCKAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 MCCLELLAN STREET
Mailing Address - Street 2:SUITE G06
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1020
Mailing Address - Country:US
Mailing Address - Phone:518-347-5537
Mailing Address - Fax:518-382-2295
Practice Address - Street 1:624 MCCLELLAN STREET
Practice Address - Street 2:SUITE G06
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1020
Practice Address - Country:US
Practice Address - Phone:518-347-5537
Practice Address - Fax:518-382-2295
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047669L208600000X
NY242030208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01978909Medicaid
PA001307325Medicaid
NYRB8920Medicare PIN
NYF39256Medicare UPIN
PA001307325Medicaid
124396Medicare ID - Type Unspecified