Organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Active
Parent organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Other names
Capital Region Urology
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
319 S MANNING BLVD SUITE 106, CAPITAL REGION UROLOGY, ALBANY, NY 12208-1743
(518) 438-1019
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03539695
—
NY
Enumeration date
09/30/2013
Last updated
04/22/2024
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