Provider Demographics
NPI:1306885066
Name:CAPITAL REGION GERIATRIC CENTER, INC.
Entity type:Organization
Organization Name:CAPITAL REGION GERIATRIC CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP-FINANCE OPERATIONS CONTINUING CA
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-831-4862
Mailing Address - Street 1:421 WEST COLUMBIA STREET
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-2217
Mailing Address - Country:US
Mailing Address - Phone:518-237-5630
Mailing Address - Fax:518-237-0904
Practice Address - Street 1:421 WEST COLUMBIA STREET
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-2217
Practice Address - Country:US
Practice Address - Phone:518-237-5630
Practice Address - Fax:518-237-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0102001N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009247OtherBLUE CROSS
NY02692515Medicaid
NY10005796OtherCDPHP
NY102471OtherWELLCARE
NY92078OtherMOHAWK VALLEY PHYSICIANS
NY000400101001OtherBLUE SHIELD OF NE NY
NY01114745Medicaid
NY01143195Medicaid
NY000400101001OtherBLUE SHIELD OF NE NY