Provider Demographics
NPI:1659744464
Name:SETON HEALTH SYSTEM
Entity Type:Organization
Organization Name:SETON HEALTH SYSTEM
Other - Org Name:SETON HEALTH OBGYN TROY
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-435-2649
Mailing Address - Street 1:4 PALISADES DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2231 BURDETT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2480
Practice Address - Country:US
Practice Address - Phone:518-268-5890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty