Provider Demographics
NPI:1821405226
Name:SKIDMORE COLLEGE HEALTH SERVICES
Entity Type:Organization
Organization Name:SKIDMORE COLLEGE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSEN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:518-580-5550
Mailing Address - Street 1:815 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-1632
Mailing Address - Country:US
Mailing Address - Phone:518-580-5550
Mailing Address - Fax:518-580-5556
Practice Address - Street 1:815 N BROADWAY
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1632
Practice Address - Country:US
Practice Address - Phone:518-580-5550
Practice Address - Fax:518-580-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333461261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service