Organization
THE JAMES A. EDDY MEMORIAL GERIATRIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUANITA WHEELER-MOORE (DIRECTOR OF CBO)
(518) 268-4906
Entity
Organization
Contact information
Practice address
2256 BURDETT AVE, TROY, NY 12180-2400
(518) 274-9890
(518) 274-5407
Mailing address
55 MOHAWK ST STE 102, COHOES, NY 12047-2600
(518) 274-9890
(518) 274-5407
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4102309N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000400135001
BLUE SHIELD OF NE NY
NY
05
—
00545208
—
NY
05
—
00872899
—
NY
01
—
009612
BLUE CROSS
NY
01
—
10030782
CDPHP
NY
01
—
7740256
AETNA
NY
Enumeration date
05/19/2006
Last updated
03/09/2015
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