Healthcare Provider Details

I. General information

NPI: 1427368034
Provider Name (Legal Business Name): HUDSON VALLEY TOTAL PODIATRIC SURGICAL CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 N PLANK RD
NEWBURGH NY
12550-2116
US

IV. Provider business mailing address

54 N PLANK RD
NEWBURGH NY
12550-2116
US

V. Phone/Fax

Practice location:
  • Phone: 718-236-1056
  • Fax:
Mailing address:
  • Phone: 718-236-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: LIZA CHOBRUTSKAYA
Title or Position: BILLING MANAGER
Credential:
Phone: 718-236-1056