Organization
JOHN D MACGILLIVRAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DOUGALD MACGILLIVRAY M.D. (OWNER)
(212) 606-1896
Entity
Organization
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 10021-4823
(212) 606-1896
(212) 774-2778
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
039252
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
042-0010337
VT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
188511
NY
Other
Enumeration date
10/23/2012
Last updated
12/12/2012
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