NPIMap

Suny Potsdam Student Health Services

Organization Active NPI Student Health Clinic/Center · Potsdam, NY

NPI 1679660336 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1679660336
Entity type
Organization (NPI type 2)
Primary specialty
Student Health Clinic/Center 261QS1000X
License
261QS1000X (NY)
Legal business name
SUNY POTSDAM STUDENT HEALTH SERVICES
Practice address
44 Pierrepont Ave
Student Health Services
Potsdam, NY 13676-2200
Phone
(315) 267-2377
NPI assigned
Oct 6, 2006
Organization subpart
No

Authorized official

Name
Mrs. Marilyn Bartlett Doelger, ANP
Title
Director of Student Health Services
Phone
(315) 267-2377

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Daniel a Spengler (269 organizations share this tax ID)

Locations

44 Pierrepont Ave
Potsdam, NY 13676
Phone (315) 267-2330

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 261QS1000X NY Yes

Addresses

Primary practice location

44 Pierrepont Ave
Student Health Services
Potsdam, NY 13676-2200

Mailing address

44 Pierrepont Ave
Potsdam, NY 13676-2200
Phone (315) 267-2377

Other identifiers

IdentifierTypeStateIssuer
301604OtherNYLICENSE NUMBER
106764OtherNYLICENSE NUMBER
301038OtherNYLICENSE NUMBER
334042OtherNYLICENSE NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679660336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 PIERREPONT AVE",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136762200",
            "telephone_number": "315-267-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 PIERREPONT AVE",
            "address_2": "STUDENT HEALTH SERVICES",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136762200",
            "telephone_number": "315-267-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNY POTSDAM STUDENT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOELGER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "BARTLETT",
        "authorized_official_title_or_position": "DIRECTOR OF STUDENT HEALTH SERVICES",
        "authorized_official_telephone_number": "315-267-2377",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NY",
            "license": "261QS1000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "301604",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "106764",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "301038",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "334042",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

All providers in Potsdam, NY · Student Health Clinic/Center in New York

Sources for this page

Verify at the official NPI Registry.