Provider Demographics
NPI:1801886072
Name:ST. CLARES HOSPITAL
Entity type:Organization
Organization Name:ST. CLARES HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPAROVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-347-5666
Mailing Address - Street 1:600 MCCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1009
Mailing Address - Country:US
Mailing Address - Phone:518-347-5660
Mailing Address - Fax:518-347-5409
Practice Address - Street 1:600 MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1009
Practice Address - Country:US
Practice Address - Phone:518-347-5666
Practice Address - Fax:518-347-5409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4601002H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000926OtherBLUE CROSS
NY040401000452OtherFIDELIS
NY10005832OtherCDPHP
NY00361748Medicaid
NY000400036000OtherBLUE SHIELD
NY04606OtherGHI
NY025OtherMOHAWK VALLEY PHYSICIANS
NY04606OtherGHI