Individual
MADISON DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6 WELLNESS WAY STE 108, LATHAM, NY 12110-2142
(518) 370-7937
(518) 377-2983
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
033347
NY
363AM0700X
Medical Physician Assistant
Primary
033347
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08166685
—
NY
Enumeration date
10/02/2024
Last updated
01/25/2026
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