Healthcare Provider Details

I. General information

NPI: 1215356308
Provider Name (Legal Business Name): ALBANY MEDICAL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SARATOGA RD SUITE 110
GLENVILLE NY
12302
US

IV. Provider business mailing address

PO BOX 417208
BOSTON MA
02241-7208
US

V. Phone/Fax

Practice location:
  • Phone: 518-264-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: VINCENT VERDILE
Title or Position: DEAN
Credential: MD
Phone: 518-262-6008