Healthcare Provider Details

I. General information

NPI: 1962971663
Provider Name (Legal Business Name): SARATOGA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MEDICAL PARK DRIVE SUITE 100
MALTA NY
12020-5050
US

IV. Provider business mailing address

PO BOX 1368
ALBANY NY
12201-1368
US

V. Phone/Fax

Practice location:
  • Phone: 518-363-8710
  • Fax: 518-363-8711
Mailing address:
  • Phone: 518-348-1276
  • Fax: 518-348-1279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

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