Provider Demographics
NPI:1033371166
Name:SARATOGA HOSPITAL
Entity Type:Organization
Organization Name:SARATOGA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-583-8346
Mailing Address - Street 1:PO BOX 412655
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:665 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:GANSEVOORT
Practice Address - State:NY
Practice Address - Zip Code:12831-1599
Practice Address - Country:US
Practice Address - Phone:518-886-5108
Practice Address - Fax:518-886-5857
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARATOGA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-30
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207RE0101X, 207V00000X, 282N00000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX IDENTIFICATION NUMBERS