Provider Demographics
NPI:1992700165
Name:VISITING NURSE ASSOCIATION OF ALBANY, INC.
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF ALBANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-489-2637
Mailing Address - Street 1:35 COLVIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1103
Mailing Address - Country:US
Mailing Address - Phone:518-489-2681
Mailing Address - Fax:518-435-0615
Practice Address - Street 1:35 COLVIN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1103
Practice Address - Country:US
Practice Address - Phone:518-489-2681
Practice Address - Fax:518-435-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0101601251E00000X
NY0101901L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473758Medicaid
NY337019Medicare ID - Type UnspecifiedPROVIDER NUMBER