Individual provider · Type 1 NPI

Mary Susan Elacqua, MD

Gynecology Physician · Troy, NY

NPI number 1316904105 Active

Practice location

101 Jordan Rd, Suite 200
Troy, NY 12180-8343

Call (518) 274-0476 Map

Fax (518) 274-0497

Mailing address

711 Troy Schenectady Rd, Suite 203
Latham, NY 12110-2442

Specialties and licenses

TaxonomyCodeLicense
Gynecology Physician Primary 207VG0400X149514 (NY)

Gynecology Physician: A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.

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About NPI 1316904105

Mary Susan Elacqua, MD's National Provider Identifier is 1316904105, issued on Apr 27, 2006. The primary taxonomy on file is Gynecology Physician (207VG0400X), and the practice location is in Troy, NY. The record was last updated on Oct 6, 2014.