Healthcare Provider Details

I. General information

NPI: 1154428431
Provider Name (Legal Business Name): SCHOOLHOUSE ROAD PEDIATRIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/02/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 SCHOOLHOUSE RD
ALBANY NY
12203-3850
US

IV. Provider business mailing address

81 SCHOOLHOUSE RD
ALBANY NY
12203-3850
US

V. Phone/Fax

Practice location:
  • Phone: 518-456-1211
  • Fax:
Mailing address:
  • Phone: 518-456-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNETTE CAMAROTA
Title or Position: MD/OWNER
Credential:
Phone: 518-456-1211