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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 Interventional Radiology Clinic
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
319 SO MANNING BLVD SUITE 304, ST. PETER'S INTERVENTIONAL RADIOLOGY CLINIC, ALBANY, NY 12208-1744
(518) 438-0600
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
NULL
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
NULL
2085U0001X
Diagnostic Ultrasound Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
02/16/2021
Last updated
10/07/2021
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