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Organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Active
Organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Active
Parent organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Authorized official
JANICE MACKE (CFO)
(518) 525-6931
Entity
Organization
Contact information
Practice address
713 TROY SCHENECTADY RD STE 304, ST. PETER'S OB/GYN AT LATHAM, LATHAM, NY 12110-2490
(518) 786-6270
(518) 786-6276
Mailing address
PO BOX 14890, ST. PETER'S PAYER CREDENTIALING, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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