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Organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Active
Organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Active
Parent organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Authorized official
JANICE MACKE (CHIEF FINANCIAL OFFICER)
(518) 525-5634
Entity
Organization
Contact information
Practice address
315 S MANNING BLVD, ALBANY, NY 12208-1707
(518) 525-6931
Mailing address
PO BOX 14890, ST. PETER'S HEALTH PARTNERS PAYER CREDENTIALING, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
204R00000X
Electrodiagnostic Medicine Physician
—
—
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/19/2017
Last updated
03/29/2017
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