Healthcare Provider Details

I. General information

NPI: 1750625976
Provider Name (Legal Business Name): ALBANY MEDICAL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 HACKETT BLVD
ALBANY NY
12208-3420
US

IV. Provider business mailing address

PO BOX 416760
BOSTON MA
02241-6760
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VINCENT VERDILE
Title or Position: DEAN ALBANY MEDICAL COLLEGE
Credential: MD
Phone: 518-262-6008