Healthcare Provider Details

I. General information

NPI: 1225768971
Provider Name (Legal Business Name): HUDSON VALLEY HEALTHCARE FAMILY HEALTH NP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 STAGE RD
MONROE NY
10950-3513
US

IV. Provider business mailing address

110 STAGE RD
MONROE NY
10950-3513
US

V. Phone/Fax

Practice location:
  • Phone: 845-248-8383
  • Fax:
Mailing address:
  • Phone: 845-248-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: DOVID FLOHR
Title or Position: CEO
Credential: FNP
Phone: 845-248-8383