Healthcare Provider Details
I. General information
NPI: 1487891016
Provider Name (Legal Business Name): FOXHALL AMBULATORY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2009
Last Update Date: 01/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64 JANSEN AVE
KINGSTON NY
12401-9989
US
IV. Provider business mailing address
PO BOX 1996
KINGSTON NY
12402-1996
US
V. Phone/Fax
- Phone: 845-943-6023
- Fax: 945-943-6077
- Phone: 845-943-6023
- Fax: 845-943-6077
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
KELLY
A
MCGINNIS
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 845-943-6023