Provider Demographics
NPI:1689749640
Name:ST. PETERS HOSPITAL OF THE CITY OF ALBANY
Entity Type:Organization
Organization Name:ST. PETERS HOSPITAL OF THE CITY OF ALBANY
Other - Org Name:SLEEP THERAPY EQUIPMENT BILLING
Other - Org Type:Other Name
Authorized Official - Title/Position:PAYER CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-525-5634
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 PINE WEST PLAZA
Practice Address - Street 2:SLEEP THERAPY EQUIPMENT
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-275-4090
Practice Address - Fax:518-275-4004
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. PETER'S HOSPITAL OF THE CITY OF ALBANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QS1200X
NY0101004H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY70034AMedicare PIN