Provider Demographics
NPI:1770911281
Name:ST. MARY'S HOSPITAL
Entity type:Organization
Organization Name:ST. MARY'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GIULIANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-842-1900
Mailing Address - Street 1:57 E FULTON ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-3212
Mailing Address - Country:US
Mailing Address - Phone:518-773-3531
Mailing Address - Fax:518-773-9103
Practice Address - Street 1:57 E FULTON ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-3212
Practice Address - Country:US
Practice Address - Phone:518-773-3531
Practice Address - Fax:518-773-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144466273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit