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NPI Code Detail

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

MEDICARE: ST. PETER'S HOSPITAL OF 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
2207Q00000XFamily Medicine Physician
3208000000XPediatrics Physician
4261QM1300XMulti-Specialty Clinic/Center
5282N00000XGeneral Acute Care Hospital
6363A00000XPhysician Assistant
7207R00000XInternal Medicine 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 : 1487725750
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. PETER'S HOSPITAL OF 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 : 53 COLUMBIA STREET
Second Line :
City : RENSSELAER
State : NY
Zip : 12144-2933
Country : US
Telephone Number : 518-434-2526
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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Directions to “ST. PETER'S HOSPITAL OF THE CITY OF ALBANY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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