Healthcare Provider Details

I. General information

NPI: 1740164631
Provider Name (Legal Business Name): UPSTATE NPS IN FAMILY HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BROADWAY
ALBANY NY
12207-2922
US

IV. Provider business mailing address

PO BOX 24
COHOES NY
12047-0024
US

V. Phone/Fax

Practice location:
  • Phone: 518-350-8700
  • Fax:
Mailing address:
  • Phone: 518-350-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERIC ROBERT SANTELL
Title or Position: OWNER
Credential:
Phone: 518-350-8700