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General NPI Number Information
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NPI Number | 1750376836
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Entity Type | Organization
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Legal Business Name | ST. PETER'S AMBULATORY SURGERY CENTER LLC
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1375 WASHINGTON AVE SUITE 201
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City | ALBANY
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State | NY
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Zip | 12206-1056
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Country | US
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Telephone | 518-533-3420
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Fax | 518-533-3424
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Provider Business Mailing Address
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Address Line | 1375 WASHINGTON AVE SUITE 201
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City | ALBANY
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State | NY
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Zip | 12206-1056
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Country | US
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Telephone | 518-533-3420
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Fax | 518-533-3424
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/ADMINISTRATOR
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Name | MR. JAMES A TORRE
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Credential |
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Telephone | 518-533-3420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 261QA1903X
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License Number State | NY
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