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General NPI Number Information
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NPI Number | 1699010355
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Entity Type | Organization
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Legal Business Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 400 PATROON CREEK BLVD ST. PETER'S URGENT CARE
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City | ALBANY
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State | NY
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Zip | 12206-5013
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Country | US
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Telephone | 518-445-4444
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Fax |
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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 |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING 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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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