Healthcare Provider Details
I. General information
NPI: 1922289545
Provider Name (Legal Business Name): HUDSON VALLEY FERTILITY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2007
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
841 ROUTE 52
FISHKILL NY
12524-1516
US
IV. Provider business mailing address
1001 W FAYETTE ST SUITE 400
SYRACUSE NY
13204-2859
US
V. Phone/Fax
- Phone: 845-705-3944
- Fax: 845-559-2600
- Phone: 315-472-1488
- Fax: 315-472-8060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
W.
LEVINE
Title or Position: PRESIDENT
Credential: MD
Phone: 845-705-3944