Basic Information
| Provider Information | |||||||||
| NPI: | 1073569331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SARATOGA HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128661046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185873222 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128661003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185873222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | STAHURA | ||||||||
| AuthorizedOfficialFirstName: | KATHLEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5185838346 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0002X | N | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | 261QX0100X | N | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine | 282N00000X | 4501000H | NY | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 0107 | 01 | NY | MVP | OTHER | 10005822 | 01 | NY | CAPITAL DISTRICT PHYSICIA | OTHER | 000400024000 | 01 | NY | BLUE SHIELD OF NORTHEASTE | OTHER | 00024 | 01 | NY | EMPIRE BLUE CROSS | OTHER | 00303282 | 05 | NY | MEDICAID |