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Organization

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

Active
Parent organization
ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Other names
Capital Region Urology
Organization subpart
Yes

Provider details

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

Contact information

Practice address
63 SHAKER RD STE 202, CAPITAL REGION UROLOGY, ALBANY, NY 12204-1030
(518) 434-1283
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03539695
NY
Enumeration date
09/30/2013
Last updated
02/08/2021
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