Healthcare Provider Details

I. General information

NPI: 1518167931
Provider Name (Legal Business Name): HUDSON VALLEY MEDICAL HOUSE CALLS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 SOUTH ST
NEWBURGH NY
12550-4117
US

IV. Provider business mailing address

367 WINDSOR HWY SUITE 435
NEW WINDSOR NY
12553-7900
US

V. Phone/Fax

Practice location:
  • Phone: 845-534-0066
  • Fax: 845-784-1594
Mailing address:
  • Phone: 845-534-0066
  • Fax: 845-784-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number223778
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number008069
License Number StateNY

VIII. Authorized Official

Name: MR. RAYMOND N MOTT III
Title or Position: DIRECTOR
Credential: PA-C
Phone: 845-534-0066