person
Dr. Mary Susan Elacqua, MD
Gynecology Physician in Troy, New York
NPI 1316904105

Mary Susan Elacqua is a Gynecology Physician based in Latham, NY and is specialized in Gynecology. Mary Susan Elacqua practices in Troy, NY and has the professional credentials of MD. The NPI Number for Mary Susan Elacqua is 1316904105 and holds a License No. 149514 (New York).

The current practice location address for Mary Susan Elacqua is 101 Jordan Rd, Troy, NY and can be reached out via phone at 518-274-0476 and via fax at 518-274-0497.

Location: 101 Jordan Rd, Troy, NY, 12110-2442
person
Provider Profile Details
NPI Number
1316904105
Provider Name
Mary Susan Elacqua
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
101 Jordan Rd, Troy, NY, 12110-2442
Phone Number
518-274-0476
Fax Number
518-274-0497
Provider Enumeration Date
04/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
141655014 01 NY EMPIRE PLAN
160007874 01 NY RAILROAD MEDICARE
16152 01 NY MVP
00858755 05 NY
113801 01 NY WELLCARE
13801 01 NY GHIHMO
10000563 01 NY CDPHP
52E361 01 NY BLUE CROSS
000416081001 01 NY BLUE SHIELD
0015055 01 NY GHI
141655014 01 NY UNITED HEALTHCARE
0005361476 01 NY AETNA
040426006334 01 NY FIDELIS
00020780401 01 NY UNIVERA
institution
Provider Business Practice Location Address Details
Address
101 Jordan Rd
City
State
Zip
12180-8343
Phone Number
518-274-0476
Fax Number
518-274-0497
person
Provider Business Mailing Address Details
Address
101 Jordan Rd
City
State
Zip
12180-8343
Phone Number
518-274-0476
Fax Number
518-274-0497
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecology
Taxonomy
License No.
149514 (New York)
Definition
Definition to come...
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