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General NPI Number Information
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NPI Number | 1053466425
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Entity Type | Organization
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Legal Business Name | ST. PETER'S HOSPITAL OF THE CITY OF ALBANY
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 1 PINE WEST PLAZA WASHINGTON AVE EXT
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City | ALBANY
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State | NY
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Zip | 12205-5537
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Country | US
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Telephone | 518-464-9999
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Fax | 518-464-9650
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Provider Business Mailing Address
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Address Line | PO BOX 14890
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City | ALBANY
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State | NY
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Zip | 12212-4890
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Country | US
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Telephone | 518-275-4090
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Fax | 518-275-4004
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Authorized Official
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Title or Position | CREDENTIALING & ENROLLMENT MANAGER
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Name | COURTNEY KNOWLES
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Credential |
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Telephone | 518-525-5634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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