Healthcare Provider Details

I. General information

NPI: 1528349024
Provider Name (Legal Business Name): HUDSON VALLEY PSYCHOLOGICAL & DEVELOPMENTAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 ROUTE 94 STE 201
NEW WINDSOR NY
12553
US

IV. Provider business mailing address

1124 ROUTE 94 STE 201
NEW WINDSOR NY
12553
US

V. Phone/Fax

Practice location:
  • Phone: 845-458-4557
  • Fax: 845-458-4559
Mailing address:
  • Phone: 845-458-4557
  • Fax: 845-458-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number014925-01
License Number StateNY

VIII. Authorized Official

Name: DR. BARRY J. SHREM
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 845-458-4557