Individual
JOHN DOUGLAD MACGILLIVRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
523 E 72ND ST, NEW YORK, NY 10021-4099
(212) 606-1896
(212) 774-2778
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4872
(212) 606-1896
(212) 774-2778
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
188511
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01946854
—
NY
Enumeration date
12/30/2005
Last updated
04/01/2021
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