St. Peters Health Partners Medical Associates PC

Organization Active NPI Family Medicine Physician · Stone Ridge, NY

NPI 1104257252 · NPPES record last updated Jul 21, 2014

Key facts

NPI
1104257252
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC
Practice address
10 Gagnon Dr
Stone Ridge, NY 12484-5120
Phone
(548) 687-7455
NPI assigned
Nov 27, 2013
Organization subpart
Yes
Parent organization (as reported)
ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PC

Authorized official

Name
Paul Gordon
Title
Cfo
Phone
(518) 525-1585

National Provider Directory

Part of
St Peter'S Health Partners Medical Associates PC

Locations

4 Palisades Dr
Ste 200
Albany, NY 12205
Phone (518) 591-1121

10 Gagnon Dr
Ste 10
Stone Ridge, NY 12484

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

10 Gagnon Dr
Stone Ridge, NY 12484-5120

Mailing address

10 Gagnon Dr
Stone Ridge, NY 12484-5120
Phone (548) 687-7455

Other providers in Stone Ridge, NY

All providers in Stone Ridge, NY · Family Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.