Provider Demographics
NPI:1811447493
Name:SETON HEALTH SYSTEM
Entity type:Organization
Organization Name:SETON HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-268-5000
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:SPHP PAYER CREDENTIALING
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-591-1121
Mailing Address - Fax:518-649-4094
Practice Address - Street 1:713 TROY SCHENECTADY RD
Practice Address - Street 2:SUITE 304
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2490
Practice Address - Country:US
Practice Address - Phone:518-375-4555
Practice Address - Fax:518-286-4911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SETON HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty