Healthcare Provider Details

I. General information

NPI: 1013396258
Provider Name (Legal Business Name): PINNACLE GROUP OF HUDSON VALLEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 PLEASANT ST
CANTON ME
04221-3144
US

IV. Provider business mailing address

3 VILLA LN
MONSEY NY
10952-1021
US

V. Phone/Fax

Practice location:
  • Phone: 207-597-2510
  • Fax:
Mailing address:
  • Phone: 845-596-6633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number2892
License Number StateME

VIII. Authorized Official

Name: MR. ISRAEL NACHFOLGER
Title or Position: CEO
Credential:
Phone: 845-596-6633