Healthcare Provider Details

I. General information

NPI: 1922435882
Provider Name (Legal Business Name): HUDSON VALLEY CARDIOVASCULAR PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 04/15/2024
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLUMBIA STREET SUITE 200
POUGHKEEPSIE NY
12601
US

IV. Provider business mailing address

100 RESERVE RD
DANBURY CT
06810-5267
US

V. Phone/Fax

Practice location:
  • Phone: 845-473-1188
  • Fax: 845-485-8937
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL DEBARBA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 203-314-6990