Healthcare Provider Details

I. General information

NPI: 1467801332
Provider Name (Legal Business Name): ALBANY MEDICAL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 MYRTLE AVE SUITE 1B
ALBANY NY
12208-3513
US

IV. Provider business mailing address

1275 BROADWAY
MENANDS NY
12204-2638
US

V. Phone/Fax

Practice location:
  • Phone: 518-264-2225
  • Fax:
Mailing address:
  • Phone: 518-262-9705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: VINCENT VERDILE
Title or Position: DEAN
Credential: MD
Phone: 518-262-6008