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NPI Code Detail

MEDICARE: GREATER HUDSON VALLEY FAMILY HEALTH CENTER, INC.

MEDICARE: GREATER HUDSON VALLEY FAMILY HEALTH CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QC1500XCommunity Health Clinic/Center

General Provider Information

NPI Number : 1457741027
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER HUDSON VALLEY FAMILY HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 3 COMMERCIAL PL
Second Line :
City : NEWBURGH
State : NY
Zip : 12550-5306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3 COMMERCIAL PL
Second Line :
City : NEWBURGH
State : NY
Zip : 12550-5306
Country : US
Telephone Number : 845-220-2146
Fax Number :
Authorized Official
Title or Position : CLINICAL COUNSELOR
Name : CURTIS POTTER
Credential : CASAC-T
Telephone Number : 845-220-2146
Provider Enumeration Date : 02/03/2015
Last Update Date : 02/03/2015

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