Provider Demographics
NPI:1437418795
Name:SARATOGA HOSPITAL
Entity Type:Organization
Organization Name:SARATOGA HOSPITAL
Other - Org Name:SCOTIA GLENVILLE FAMILY PHYSICIANS
Other - Org Type:Other Name
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 1:112 CHARLTON RD
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-2547
Practice Address - Country:US
Practice Address - Phone:518-399-7723
Practice Address - Fax:518-399-6428
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARATOGA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-08
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty