Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Magnolia Dermatology, PLLC

Organization Dermatology Physician · NPI 1932889102

Magnolia Dermatology, PLLC is a Dermatology Physician in Latham, New York. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

582 New Loudon Rd
Latham, NY 12110-4059
Phone: (518) 888-2012
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1932889102
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Virginia Tracey — Member · (518) 888-2012
NPI enumeratedJuly 21, 2023
Last updated in NPPESMay 13, 2024
Certification dateMay 13, 2024
Mailing address1 Loudon Hts S, Loudonville, NY 12211-2013

Other providers in Latham