Basic Information
| Provider Information | |||||||||
| NPI: | 1962971663 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SARATOGA HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1368 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122011368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183481276 | ||||||||
| FaxNumber: | 5183481279 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 MEDICAL PARK DRIVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MALTA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120205050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183638710 | ||||||||
| FaxNumber: | 5183638711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2018 | ||||||||
| LastUpdateDate: | 11/30/2018 | ||||||||
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| AuthorizedOfficialLastName: | FOSTER | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | VP/CFO | ||||||||
| AuthorizedOfficialTelephone: | 5185838421 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SARATOGA HOSPITAL | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
No ID Information.