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ST. PETER'S HOSPITAL OF THE CITY OF ALBANY NPI 1407937477


NPI Information

NPI: 1407937477
Provider Name: ST. PETER'S HOSPITAL OF THE CITY OF ALBANY

Other Name: ST. PETER'S ADDICTION RECOVERY CENTER

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 33D0890711

Address:
3 MERCYCARE LANE
GUILDERLAND, NY
ZIP 12084
Phone: (518) 452-6700
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ST. PETER'S HOSPITAL OF THE CITY OF ALBANY is a rehabilitation and substance use disorder clinic center in Guilderland, NY. ST. PETER'S HOSPITAL OF THE CITY OF ALBANY NPI is 1407937477. The provider is registered as an organization entity type.
The provider Other Name Is St. Peter's Addiction Recovery Center.

The provider's business location address is:

3 MERCYCARE LANE
GUILDERLAND, NY
ZIP 12084-504
Phone: (518) 452-6700

The provider's authorized official is Courtney Knowles .
The authorized official title is Credentialing Manager and has the following contact phone number (518) 525-5634.

The CLIA number assigned to this NPI record is 33D0890711 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 10/11/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1282N00000XGeneral Acute Care Hospital0101004HNEW YORKNo
2363A00000XPhysician AssistantNo
3363L00000XNurse PractitionerNo
4363LF0000XNurse PractitionerFamilyNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
62084P0800XPsychiatry & NeurologyPsychiatryNo
7207Q00000XFamily MedicineNo
8207QA0401XFamily MedicineAddiction MedicineNo
9207R00000XInternal MedicineNo
10261QM1300XClinic/CenterMulti-SpecialtyNo
11261QR0405XClinic/CenterRehabilitation, Substance Use Disorder0101004HNEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100318823MEDICAIDNEW YORK
210005852OTHERNEW YORKREHAB SUBSTANCE USE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.