Healthcare Provider Details
I. General information
NPI: 1598133100
Provider Name (Legal Business Name): HEALTH QUEST MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2015
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
45 READE PL
POUGHKEEPSIE NY
12601-3947
US
IV. Provider business mailing address
1351 ROUTE 55 SUITE 200
LAGRANGEVILLE NY
12540-5108
US
V. Phone/Fax
- Phone: 845-454-8500
- Fax:
- Phone: 845-475-9661
- Fax: 845-475-9938
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFF
KRUGER
Title or Position: VP FINANCE
Credential:
Phone: 845-475-9661