Healthcare Provider Details

I. General information

NPI: 1760651855
Provider Name (Legal Business Name): THE KINGSTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BARBAROSA LN
KINGSTON NY
12401-1220
US

IV. Provider business mailing address

2 BARBAROSA LN
KINGSTON NY
12401-1220
US

V. Phone/Fax

Practice location:
  • Phone: 845-331-3131
  • Fax: 845-943-6077
Mailing address:
  • Phone: 845-331-3131
  • Fax: 845-943-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number StateNY

VIII. Authorized Official

Name: MS. KELLY A MCGINNIS
Title or Position: DIRECTOR OF PFS
Credential:
Phone: 845-943-6023