Provider Demographics
NPI:1568952380
Name:SARATOGA HOSPITAL
Entity Type:Organization
Organization Name:SARATOGA HOSPITAL
Other - Org Name:MECHANICVILLE FAMILY PRACTICE
Other - Org Type:Other Name
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-587-3222
Mailing Address - Street 1:202 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-3522
Mailing Address - Country:US
Mailing Address - Phone:518-580-2099
Mailing Address - Fax:518-580-2098
Practice Address - Street 1:202 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118
Practice Address - Country:US
Practice Address - Phone:518-580-2099
Practice Address - Fax:518-580-2098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARATOGA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty