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63 Shaker Road Suite G01 St. Peter's Ms And Headache Center Albany NY 12204-1030 | |
| (518) 213-1443 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 63 Shaker Road Suite G01, Albany, New York |
| Authorized Official Name and Position | Courtney Knowles (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5185255634 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 14890 Albany NY 12212-4890 Ph: () - | 63 Shaker Road Suite G01 St. Peter's Ms And Headache Center Albany NY 12204-1030 Ph: (518) 213-1443 |
| NPI Number | 1457706731 |
|---|---|
| Provider Enumeration Date | 04/25/2016 |
| Last Update Date | 10/07/2021 |
| Certification Date | 10/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457706731 | NPI | - | NPPES |
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