Healthcare Provider Details

I. General information

NPI: 1629491329
Provider Name (Legal Business Name): ALBANY MEDICAL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PATROON CREEK BLVD SUITE 210
ALBANY NY
12206-5013
US

IV. Provider business mailing address

1275 BROADWAY # MC106
MENANDS NY
12204-2638
US

V. Phone/Fax

Practice location:
  • Phone: 518-459-8106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology 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