Healthcare Provider Details
I. General information
NPI: 1649805136
Provider Name (Legal Business Name): HEALTH QUEST MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
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 STE 200
LAGRANGEVILLE NY
12540-5128
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 | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
BERZINSKY
Title or Position: VP FINANCE
Credential:
Phone: 845-475-9661