Healthcare Provider Details

I. General information

NPI: 1194643056
Provider Name (Legal Business Name): ALBANY MEDICAL COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1499 NEW SCOTLAND RD
SLINGERLANDS NY
12159-9209
US

IV. Provider business mailing address

PO BOX 416760
BOSTON MA
02241-6760
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5057
  • Fax: 518-264-8257
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN BOULOS
Title or Position: EVP & DEAN OF COLLEGE
Credential:
Phone: 518-262-6008