Healthcare Provider Details

I. General information

NPI: 1326093972
Provider Name (Legal Business Name): HUDSON VALLEY THORACIC & VASCULAR ASSOC. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 HATFIELD LN SUITE 202
GOSHEN NY
10924-6734
US

IV. Provider business mailing address

70 HATFIELD LN SUITE 202
GOSHEN NY
10924-6734
US

V. Phone/Fax

Practice location:
  • Phone: 845-291-3656
  • Fax:
Mailing address:
  • Phone: 845-291-3656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number147810
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number147810
License Number StateNY

VIII. Authorized Official

Name: MARK ELLIS GINSBURG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 845-362-0075