Provider Demographics
NPI:1609806520
Name:ALBANY MEDICAL CENTER HOSPITAL
Entity Type:Organization
Organization Name:ALBANY MEDICAL CENTER HOSPITAL
Other - Org Name:AMCH DEPT OF RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP, CHIEF FINANCIAL OFFIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:SPREER-ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-262-8795
Mailing Address - Street 1:618 CENTRAL AVE
Mailing Address - Street 2:MAIL CODE 106
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206
Mailing Address - Country:US
Mailing Address - Phone:518-262-9702
Mailing Address - Fax:518-262-9707
Practice Address - Street 1:43 NEW SCOTLAND AVE
Practice Address - Street 2:MAIL CODE 113
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-262-8481
Practice Address - Fax:518-262-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Multi-Specialty
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological PhysicsGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01520676Medicaid
VT1000120Medicaid
NY02333544Medicaid
NY02333544Medicaid
NYCK2799Medicare ID - Type UnspecifiedRR