Provider Demographics
NPI:1881997104
Name:ST. PETER'S HOSPITAL
Entity type:Organization
Organization Name:ST. PETER'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR PHYSICIANS BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-275-4090
Mailing Address - Street 1:317 S MANNING BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1739
Mailing Address - Country:US
Mailing Address - Phone:518-525-5215
Mailing Address - Fax:518-525-5505
Practice Address - Street 1:317 S MANNING BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1739
Practice Address - Country:US
Practice Address - Phone:518-525-5215
Practice Address - Fax:518-525-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2591332086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty