# SAMARITAN HOSPITAL OF TROY, NEW YORK

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAMARITAN HOSPITAL OF TROY, NEW YORK
- **Other names:** Capital Region Diabetes & Endocrine Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790120368
- **Legal business name:** SAMARITAN HOSPITAL OF TROY, NEW YORK
- **Authorized official:** COURTNEY KNOWLES (CREDENTIALING MANAGER)
- **Authorized official phone:** (518) 525-5634

## Contact information

- **Practice address:** 158 SARATOGA AVENUE, WATERFORD, NY 12188-2205
- **Practice address phone:** (518) 233-1162
- **Mailing address:** PO BOX 14890, ALBANY, NY 12212-4890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | — | — | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | — | — |
| 282N00000X | General Acute Care Hospital | 4102002H | NY | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 10/11/2021