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NPI Code Detail

MEDICARE: ST. PETER'S HOSPITALOF THE CITY OF ALBANY

MEDICARE: ST. PETER'S HOSPITALOF THE CITY OF ALBANY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner
2363LW0102XWomen's Health Nurse Practitioner
3261QM1300XMulti-Specialty Clinic/Center
4282N00000XGeneral Acute Care Hospital
5363A00000XPhysician Assistant
6176B00000XMidwife
7207Q00000XFamily Medicine Physician
8207R00000XInternal Medicine Physician
9208000000XPediatrics Physician
10207V00000XObstetrics & Gynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386715621
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. PETER'S HOSPITALOF THE CITY OF ALBANY
Provider Business Mailing Address
First Line : PO BOX 14890
Second Line :
City : ALBANY
State : NY
Zip : 12212-4890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 326 SOUTH PEARL STREET
Second Line :
City : ALBANY
State : NY
Zip : 12202-1914
Country : US
Telephone Number : 518-449-0100
Fax Number :
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : COURTNEY KNOWLES
Credential :
Telephone Number : 518-525-5634
Provider Enumeration Date : 11/10/2006
Last Update Date : 10/11/2021

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1235121351 — GEORGE P FORREST MD
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326 S PEARL ST
ALBANY, NY
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1083651616 — MS. SUSAN CZARNECKI LASKER FNP
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1578501623 — SHRAVAN RAJ SAXENA MD
Practice Location Address:
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1346305505 — MS. MARIANNE TSIKITAS R.D., C.D.N.
Practice Location Address:
326 S PEARL ST , ST. PETER'S HOSPITAL FAMILY HEALTH CENTER
ALBANY, NY
12202-1914
Practice Phone: 518-449-0100
Practice Fax:

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