Healthcare Provider Details
I. General information
NPI: 1255810347
Provider Name (Legal Business Name): COBBLE HILL ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2018
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1182 TROY SCHENECTADY RD STE 201
LATHAM NY
12110-1000
US
IV. Provider business mailing address
36 E COBBLE HILL RD
LOUDONVILLE NY
12211-1310
US
V. Phone/Fax
- Phone: 518-649-8082
- Fax: 518-649-8123
- Phone: 781-325-3286
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0500X |
| Taxonomy | Infusion Therapy Registered Nurse |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A2900X |
| Taxonomy | Neurocritical Care Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084D0003X |
| Taxonomy | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084E0001X |
| Taxonomy | Epilepsy Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0008X |
| Taxonomy | Neuromuscular Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0402X |
| Taxonomy | Neurology with Special Qualifications in Child Neurology Physician |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0005X |
| Taxonomy | Neurodevelopmental Disabilities Physician |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0301X |
| Taxonomy | Brain Injury Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P2900X |
| Taxonomy | Pain Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251N0400X |
| Taxonomy | Neurology Physical Therapist |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
PIPER
Title or Position: ADMINSTRATOR
Credential:
Phone: 518-956-4946