Healthcare Provider Details

I. General information

NPI: 1588106223
Provider Name (Legal Business Name): HEALTHALLIANCE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2016
Last Update Date: 11/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 BROADWAY
KINGSTON NY
12401-4626
US

IV. Provider business mailing address

1157 DOGWOOD ST # 3
KINGSTON NY
12401-1033
US

V. Phone/Fax

Practice location:
  • Phone: 845-331-3131
  • Fax:
Mailing address:
  • Phone: 571-606-2741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHLEY NICOLE ARZADON
Title or Position: PHYSICIAN/RESIDENT
Credential: DPM
Phone: 571-606-2741