Healthcare Provider Details

I. General information

NPI: 1841103769
Provider Name (Legal Business Name): DR. PERQUIDA PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 11196
NEWBURGH NY
12552-1196
US

IV. Provider business mailing address

PO BOX 11196
NEWBURGH NY
12552-1196
US

V. Phone/Fax

Practice location:
  • Phone: 845-779-1420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number085693
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: