MEDICARE: BRIDGE CENTER OF SCHENECTADY, INC.

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
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1821273764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGE CENTER OF SCHENECTADY, INC.

Provider Business Mailing Address
First Line	:	72 UNION AVE
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12308-2430
Country	:	US
Telephone Number	:	518-346-1277
Fax Number	:	518-346-1152

Provider Business Practice Location Address
First Line	:	72 UNION AVE
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12308-2430
Country	:	US
Telephone Number	:	518-346-1277
Fax Number	:	518-346-1152

Authorized Official
Title or Position	:	ADMINISTRATIVE MANAGER
Name	:	MS. LINDA C. FAY
Credential	:
Telephone Number	:	518-346-1277

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	01/09/2008

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