Provider Demographics
NPI:1851401186
Name:COUNTY OF ALBANY DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:COUNTY OF ALBANY DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER OF HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:CRUCETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:518-447-4695
Mailing Address - Street 1:175 GREEN STREET
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12202-2011
Mailing Address - Country:US
Mailing Address - Phone:518-447-4580
Mailing Address - Fax:518-447-4698
Practice Address - Street 1:175 GREEN STREET
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202-2011
Practice Address - Country:US
Practice Address - Phone:518-447-4580
Practice Address - Fax:518-447-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473616Medicaid
NY337062Medicare UPIN
NY00473616Medicaid