1508280389 NPI number — ALBANY MEDICAL COLLEGE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508280389 NPI number — ALBANY MEDICAL COLLEGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBANY MEDICAL COLLEGE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALBANY MED DIVISION OF COMMUNITY ENDOCRINOLOGY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508280389
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1275 BROADWAY # MC106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENANDS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12204-2638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-262-9705
Provider Business Mailing Address Fax Number:
518-262-9738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1365 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12206-1098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-489-4704
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2014

Additional Information

Authorized Official

Authorized Official Last Name:
VERDILE
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
Authorized Official Title or Position:
DEAN ALBANY MEDICAL COLLEGE
Authorized Official Telephone Number:
518-262-6008

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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