Healthcare Provider Details

I. General information

NPI: 1801886072
Provider Name (Legal Business Name): ST. CLARES HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 09/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MCCLELLAN ST
SCHENECTADY NY
12304-1009
US

IV. Provider business mailing address

600 MCCLELLAN ST
SCHENECTADY NY
12304-1009
US

V. Phone/Fax

Practice location:
  • Phone: 518-347-5666
  • Fax: 518-347-5409
Mailing address:
  • Phone: 518-347-5660
  • Fax: 518-347-5409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4601002H
License Number StateNY

VIII. Authorized Official

Name: MR. EDWARD GASPAROVIC
Title or Position: VICE PRESIDENT OF FINANCE, CFO
Credential:
Phone: 518-347-5666