1841226594 NPI number — ALBANY MEDICAL COLLEGE

Table of content: (NPI 1841226594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841226594 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:
ALABANY MEDICAL COLLEGE DEPT OF ANESTHESIA
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:
1841226594
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 # 106
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:
518-262-9638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47 NEW SCOTLAND AVE
Provider Second Line Business Practice Location Address:
MAIL CODE 131
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-262-4317
Provider Business Practice Location Address Fax Number:
518-262-2671
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 00451198 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9766804 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01520676 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1006966 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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