Healthcare Provider Details

I. General information

NPI: 1902846579
Provider Name (Legal Business Name): CORNELIUS R VERHOEST JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2507 SOUTH RD CAREMOUNT MEDICAL PC
POUGHKEEPSIE NY
12601-5458
US

IV. Provider business mailing address

110 S BEDFORD RD CAREMOUNT MEDICAL PC
MOUNT KISCO NY
10549-3446
US

V. Phone/Fax

Practice location:
  • Phone: 845-231-5600
  • Fax: 845-432-3932
Mailing address:
  • Phone: 914-241-1050
  • Fax: 914-242-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number166013
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number166013
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: