Doctor Name: | DR. DOUGLAS M. HARGRAVE |
NPI Number: | 1225001761 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 164432-1 |
Business Practice Address: | 455 Patroon Creek Blvd. Suite 101 Albany, NY - 12206 |
Business Phone Number: | 5184380505 |
Business Fax Number: | 5184384517 |
Mailing Address: | 455 Patroon Creek Blvd., Suite 101 ALBANY |
State: | NY |
Postal Code: | 12206 |
Phone Number: | 5184380505 |
Fax Number: | 5184384517 |
NPI Enumeration Date: | 02/07/2006 |
NPI Last Update Date: | 01/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 164432-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |