| Organization Name: | ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PC |
| NPI Number: | 1144565714 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL GORDON (DIR FIN/ADMIN PHYS ENTERPRISE) |
| Mailing Address: | 1444 Western Ave Suite B-2 Albany |
| State: | NY US |
| Postal Code: | 122033440 |
| Phone Number: | 5184588014 |
| Fax Number: | 5185336714 |
| NPI Enumeration Date: | 12/07/2012 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |