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Organization

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

Active
Parent organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Other names
St. Peter's Breast Surgery
Organization subpart
Yes

Provider details

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

Contact information

Practice address
317 SOUTH MANNING BLVD SUITE C364, ST PETER'S BREAST SURGERY, ALBANY, NY 12208-1738
(518) 641-6936
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
261QM1300X
Multi-Specialty Clinic/Center
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
12/10/2013
Last updated
10/07/2021
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