# ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** 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:** 1528651015
- **Legal business name:** ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
- **Authorized official:** COURTNEY KNOWLES (CREDENTIALING MANAGER)
- **Authorized official phone:** (518) 525-5634

## Contact information

- **Practice address:** 319 SO MANNING BLVD SUITE 304, ST. PETER'S INTERVENTIONAL RADIOLOGY CLINIC, ALBANY, NY 12208-1744
- **Practice address phone:** (518) 438-0600
- **Mailing address:** PO BOX 14890, ALBANY, NY 12212-4890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | — |
| 2085B0100X | Body Imaging Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 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