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

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES
- **Other names:** St. Peter's Pediatrics
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750626404
- **Legal business name:** ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES
- **Authorized official:** COURTNEY KNOWLES (MANAGER CREDENTIALING & ENROLLMENT)
- **Authorized official phone:** (518) 525-5634

## Contact information

- **Practice address:** 400 PATROON CREEK BLVD SUITE 200, ST. PETER'S PEDIATRICS, ALBANY, NY 12206-5014
- **Practice address phone:** (518) 525-2445
- **Practice address fax:** (518) 475-7069
- **Mailing address:** PO BOX 14890, ALBANY, NY 12212-4890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/06/2012
- **Last updated:** 08/29/2023