Provider Demographics
NPI:1770307670
Name:EMPIRE BARIATRICS PLLC
Entity type:Organization
Organization Name:EMPIRE BARIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:315-575-3410
Mailing Address - Street 1:5 SOUTHSIDE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3870
Mailing Address - Country:US
Mailing Address - Phone:315-575-3410
Mailing Address - Fax:
Practice Address - Street 1:7 SOUTHWOODS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2526
Practice Address - Country:US
Practice Address - Phone:518-641-6580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty