Healthcare Provider Details

I. General information

NPI: 1417357716
Provider Name (Legal Business Name): DUTCHESS MEDICAL ASSOCIATE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WESTAGE BUSINESS CTR DR STE 320
FISHKILL NY
12524-2265
US

IV. Provider business mailing address

200 WESTAGE BUSINESS CTR DR STE 320
FISHKILL NY
12524-2265
US

V. Phone/Fax

Practice location:
  • Phone: 845-831-0471
  • Fax: 845-831-0306
Mailing address:
  • Phone: 845-831-0471
  • Fax: 845-831-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number140194
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number140194
License Number StateNY

VIII. Authorized Official

Name: PHILIP TOTONELLY
Title or Position: OWNER
Credential: MD
Phone: 845-831-0471