# NORTHWAY SPC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992186852
- **Authorized official:** KASANDRA A. HOPKINS RN, MSN (ADMINISTRATOR)
- **Authorized official phone:** (518) 371-6772

## Contact information

- **Practice address:** 1596 ROUTE 9, HALFMOON, NY 12065
- **Practice address phone:** (518) 322-7720
- **Mailing address:** 1596 ROUTE 9, HALFMOON, NY 12065-4303
- **Mailing address phone:** (518) 371-6772
- **Mailing address fax:** (518) 288-2835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 4552201R | NY | Yes |

## Other

- **Enumeration date:** 06/16/2015
- **Last updated:** 04/07/2016