Healthcare Provider Details

I. General information

NPI: 1477071710
Provider Name (Legal Business Name): HUDSON VALLEY FOOT ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 09/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LITTLE BRITAIN RD STE 101
NEWBURGH NY
12550-5161
US

IV. Provider business mailing address

103 HURLEY AVE
KINGSTON NY
12401-2829
US

V. Phone/Fax

Practice location:
  • Phone: 845-562-1271
  • Fax: 845-331-6894
Mailing address:
  • Phone: 845-339-4191
  • Fax: 845-331-6894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNY

VIII. Authorized Official

Name: MR. CHARLES WALKER
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 845-339-4191