Provider Demographics
NPI:1700120482
Name:SARATOGA HOSPITAL
Entity Type:Organization
Organization Name:SARATOGA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-583-8346
Mailing Address - Street 1:PO BOX 412655
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 CARE LN
Practice Address - Street 2:300
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8639
Practice Address - Country:US
Practice Address - Phone:518-226-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARATOGA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-19
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100083138Medicare PIN