Healthcare Provider Details

I. General information

NPI: 1922482264
Provider Name (Legal Business Name): SARATOGA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CHARLTON RD CDPHP SITE
BALLSTON LAKE NY
12019-2547
US

IV. Provider business mailing address

PO BOX 1220
ALBANY NY
12201-1220
US

V. Phone/Fax

Practice location:
  • Phone: 518-399-7723
  • Fax: 518-399-6428
Mailing address:
  • Phone: 518-348-1276
  • Fax: 518-348-1279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GARY FOSTER
Title or Position: VP/CFO
Credential:
Phone: 518-583-8421