Provider Demographics
NPI:1508919614
Name:GLENS FALLS HOSPITAL
Entity Type:Organization
Organization Name:GLENS FALLS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIMECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-926-5902
Mailing Address - Street 1:1 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3617
Mailing Address - Country:US
Mailing Address - Phone:518-926-7100
Mailing Address - Fax:
Practice Address - Street 1:1 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3617
Practice Address - Country:US
Practice Address - Phone:518-926-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLENS FALLS HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-19
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051222-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health