Provider Demographics
NPI:1811448657
Name:ALBANY MEDICAL CENTER HOSPITAL
Entity type:Organization
Organization Name:ALBANY MEDICAL CENTER HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP, CHIEF FINANCIAL OFFIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPREER-ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-262-8795
Mailing Address - Street 1:43 NEW SCOTLAND AVE
Mailing Address - Street 2:MC-29
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-8795
Mailing Address - Fax:518-262-5306
Practice Address - Street 1:1365 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1068
Practice Address - Country:US
Practice Address - Phone:518-264-6825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBANY MEDICAL CENTER HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-17
Last Update Date:2017-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0101000H261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03000364Medicaid
NY330013Medicare Oscar/Certification