Provider Demographics
NPI:1326102005
Name:AMSTERDAM MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:AMSTERDAM MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-842-3100
Mailing Address - Street 1:4988 STATE HIGHWAY 30
Mailing Address - Street 2:PO BOX 517
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7520
Mailing Address - Country:US
Mailing Address - Phone:518-842-3100
Mailing Address - Fax:518-841-3678
Practice Address - Street 1:4988 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7520
Practice Address - Country:US
Practice Address - Phone:518-842-3100
Practice Address - Fax:518-841-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2801000H275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000005323OtherGHI
NY6450165OtherAETNA
NY000400002001OtherBSNENY
NY000902OtherEMPIRE
NY00381420Medicaid
NY0129OtherMVP
NY10005722OtherCDPHP
NY000400002003OtherBSNENY
NY0129OtherMVP
NY00381420Medicaid