Provider Demographics
NPI:1982094827
Name:SARATOGA REGIONAL MEDICAL , P.C
Entity Type:Organization
Organization Name:SARATOGA REGIONAL MEDICAL , P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:METHVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-580-2135
Mailing Address - Street 1:PO BOX 10008
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-5008
Mailing Address - Country:US
Mailing Address - Phone:518-348-1276
Mailing Address - Fax:518-348-1279
Practice Address - Street 1:2911 ROUTE 9
Practice Address - Street 2:SUITE 1
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-3975
Practice Address - Country:US
Practice Address - Phone:518-363-8815
Practice Address - Fax:518-363-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty