Healthcare Provider Details
I. General information
NPI: 1962742510
Provider Name (Legal Business Name): HEALTH QUEST MEDICAL PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2013
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 ROUTE 52
CARMEL NY
10512-1200
US
IV. Provider business mailing address
1351 ROUTE 55 SUITE 200
LAGRANGEVILLE NY
12540-5108
US
V. Phone/Fax
- Phone: 845-228-2910
- Fax: 845-228-2914
- Phone: 845-475-9661
- Fax: 845-475-9938
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARUN
AGARWAL
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 845-475-9661