| NPI | 1770829616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: NY 4102002H) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 4102002H) |
| 207R00000X Internal Medicine | |
| 207RI0200X Internal Medicine Infectious Disease | |
| 208600000X Surgery (Licence: NY 4102002H) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2022-03-07 |