Healthcare Provider Details

I. General information

NPI: 1477667145
Provider Name (Legal Business Name): BELLEVUE WOMAN'S MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 TROY ROAD
NISKAYUNA NY
12309-4797
US

IV. Provider business mailing address

2210 TROY ROAD
NISKAYUNA NY
12309-4797
US

V. Phone/Fax

Practice location:
  • Phone: 518-346-9400
  • Fax: 518-346-9416
Mailing address:
  • Phone: 518-346-9400
  • Fax: 518-346-9416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NW0100X
TaxonomyWomen's Hospital
License Number4652001H
License Number StateNY

VIII. Authorized Official

Name: MRS. COLLEEN SUSKO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 518-346-9411