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NPI Code Detail

MEDICARE: ST. MARY'S HEALTHCARE

MEDICARE: ST. MARY'S HEALTHCARE
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
1261QP2300XPrimary Care Clinic/Center
2282N00000XGeneral Acute Care Hospital2801001HNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811977796
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. MARY'S HEALTHCARE
Provider Business Mailing Address
First Line : 427 GUY PARK AVE
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-1054
Country : US
Telephone Number : 518-842-1900
Fax Number :
Provider Business Practice Location Address
First Line : 427 GUY PARK AVE
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-1054
Country : US
Telephone Number : 518-842-1900
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : JEFFREY M. METHVEN
Credential :
Telephone Number : 518-841-7101
Provider Enumeration Date : 01/18/2006
Last Update Date : 06/25/2025

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Directions to “ST. MARY'S HEALTHCARE ” Practice Location

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