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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, P.C.
Other names
St. Peter's Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Authorized official
COURTNEY KNOWLES (CREDENTIALING MANAGER)
(518) 525-5634
Entity
Organization
Contact information
Practice address
582 NEW LOUDON RD, ST PETER'S INTERNAL MEDICINE, LATHAM, NY 12110-5709
(518) 783-0072
(518) 783-8138
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/07/2012
Last updated
10/07/2021
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