Healthcare Provider Details

I. General information

NPI: 1952720476
Provider Name (Legal Business Name): ALBANY MEDICAL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2014
Last Update Date: 04/11/2014
Certification Date:
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

PO BOX 417861
BOSTON MA
02241-7861
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: VINCENT VERDILE
Title or Position: DEAN
Credential: MD
Phone: 518-262-6008